Rex Dator De Asis, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

2022049977 Issued in MO

Practice address

5720 Ruddell Rd SE
# Unit B
Lacey, WA 98503

Phone

(360) 438-0805

Fax

(360) 528-2219

NPI assigned

Oct 17, 2006

Sex

Male

Sole proprietor

No

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 MO

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

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Great Mines Health Center

  • Federally Qualified Health Center (FQHC)
  • Potosi, MO
  • NPI 1376536953
  Medicare reassignment NPD
• Great Mines Health Center

  dba Farmington R-VII - Dayse Baker Learning Center

  • Federally Qualified Health Center (FQHC)
  • Farmington, MO
  • NPI 1073188462
  NPD

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1891875514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5720 RUDDELL RD SE",
            "address_2": "# UNIT B",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "98503",
            "telephone_number": "360-438-0805",
            "fax_number": "360-528-2219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5720 RUDDELL RD SE",
            "address_2": "# UNIT B",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "98503",
            "telephone_number": "360-438-0805",
            "fax_number": "360-528-2219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE ASIS",
        "first_name": "REX",
        "middle_name": "DATOR",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2022049977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynda Davis
• Madisen Davis
• Maile Anne Davis
• Tara Lynn Davis, L.AC
• Victoria Lynn Davis, LCSW
• Michaela Jane De Groot, PT, DPT
• Gerson A De Peralta
• Lorraine Blas De Vera, OTR/L
• Cynthia D Dean, LMP
• Patricia Dean

• Dentist in Lacey, WA
• Providers in Lacey, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2025; 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.