Active NPI
Makenzie M Davis
- Dentist
- Lehi, UT
National Provider Identifier
1891486593
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 13996047-9926
- Practice address
- 181 N 1200 E
Lehi, UT 84043-2446 - Phone
- (801) 855-0555
- NPI assigned
- May 15, 2023
- 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 | 13996047-9926 | UT | Primary |
Addresses
Primary practice location
181 N 1200 E
Lehi, UT 84043-2446
Mailing address
6283 W Skyline Dr N
Highland, UT 84003-3756
Phone (801) 664-5264
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240625001609 | UT | Order and Referring Only - Dentist | 2769925205 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13996047-9926 | UT | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716336000000",
"number": "1891486593",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6283 W SKYLINE DR N",
"city": "HIGHLAND",
"state": "UT",
"postal_code": "840033756",
"telephone_number": "801-664-5264"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "181 N 1200 E",
"city": "LEHI",
"state": "UT",
"postal_code": "840432446",
"telephone_number": "801-855-0555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "MAKENZIE",
"middle_name": "M",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-05-15",
"last_updated": "2024-05-22",
"certification_date": "2024-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "UT",
"license": "13996047-9926",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lehi, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; 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.