Gary Davis DDS Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

52166 Issued in CA

Legal business name

GARY DAVIS DDS INC

Practice address

27758 Santa Margarita Pkwy
Suite334
Mission Viejo, CA 92691-6709

Phone

(949) 554-4844

NPI assigned

Feb 19, 2007

Organization subpart

No

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

Authorized official

Name

Gary Stephen Davis, DDS

Title

Ceo

Phone

(949) 554-4844

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373932800000",
    "number": "1891839072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27758 SANTA MARGARITA PKWY",
            "address_2": "SUITE334",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27758 SANTA MARGARITA PKWY",
            "address_2": "SUITE334",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916709",
            "telephone_number": "949-554-4844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY DAVIS DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-19",
        "last_updated": "2013-07-16",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "STEPHEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "949-554-4844",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "52166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PDA HOLDINGS LLC DBA MAGIC SMILES",
            "identifier": "1134345937",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "232643",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Gastroenterology and Endoscopy Institute of Orange County

• General Practice Dentistry in Mission Viejo, CA
• Providers in Mission Viejo, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.