Active NPI
Dillon Alexander Davis, D.M.D
- Dentist
- Jacksonville, FL
National Provider Identifier
1891147914
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 22113
- Practice address
- 1403 Dunn Ave
Jacksonville, FL 32218-6346 - Phone
- (904) 751-3444
- NPI assigned
- Jul 13, 2016
- Last updated
- Jul 13, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 22113 | FL | Primary |
Addresses
Primary practice location
1403 Dunn Ave
Jacksonville, FL 32218-6346
Mailing address
421 W Church St
#522
Jacksonville, FL 32202-4173
Phone (870) 918-9353
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22113 | FL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468368000000",
"number": "1891147914",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "421 W CHURCH ST",
"address_2": "#522",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322024173",
"telephone_number": "870-918-9353"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1403 DUNN AVE",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322186346",
"telephone_number": "904-751-3444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "DILLON",
"middle_name": "ALEXANDER",
"name_prefix": "Dr.",
"credential": "D.M.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-07-13",
"last_updated": "2016-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "22113",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.