Nicholas Davidson, D.D.S

Primary specialty

DentistTaxonomy code 122300000X

License

2901020201 Issued in MI

Practice address

21080 Allen Rd
Woodhaven, MI 48183-1602

Phone

(734) 676-1656

NPI assigned

Oct 28, 2010

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1288224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288224000000",
    "number": "1871893511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21080 ALLEN RD",
            "city": "WOODHAVEN",
            "state": "MI",
            "postal_code": "481831602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21080 ALLEN RD",
            "city": "WOODHAVEN",
            "state": "MI",
            "postal_code": "481831602",
            "telephone_number": "734-676-1656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-10-28",
        "last_updated": "2010-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901020201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Marie Conner, CPHT
• Miranda Cunningham, RN
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• Gino D'Agostino, DPT
• Alyssa Daugherty
• Dental House - Downriver
• Valerie Leigh Desmond, RPH
• Dexter K Flemming DDS Ms PC (Michigan Center for Oral Surgery)
• Garry Dean Dotson, RPH
• Downriver Family Care

• Dentist in Woodhaven, MI
• Providers in Woodhaven, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.