Individual provider Active NPI

Kaitlin Elizabeth Davis

  • Pediatric Dentistry
  • Chevy Chase, MD
National Provider Identifier
1902435779
Registry record updated Aug 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
18935 Issued in MD
Practice address
5530 Wisconsin Ave Ste 1230
Chevy Chase, MD 20815-4301
Phone
(301) 962-2166
NPI assigned
Apr 3, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 105504 CA
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Dentistry 1223P0221X 18935 MD Primary

Addresses

Primary practice location

5530 Wisconsin Ave Ste 1230
Chevy Chase, MD 20815-4301

Mailing address

4909 Auburn Ave Apt 1103
Bethesda, MD 20814-2839
Phone (818) 793-6219

Other practice location 1

16542 Ventura Blvd Ste 506
Encino, CA 91436-4577
Phone (818) 943-8228

Other practice location 2

2515 Eastbluff Dr
Newport Beach, CA 92660-3504
Phone (949) 640-5050

Other practice location 3

10833 Le Conte Ave
Los Angeles, CA 90095-3075
Phone (310) 825-9789

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

LicenseStateTypeSpecialty
105504CAMDPediatric Dentist
18935MDMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Lecia Harmer, DDS, Inc Pediatric Dentistry CurrentSince Nov 1, 2022 Accepting new patients
Hedieh Tavajohi-Kermani, DDS, MDS, Inc Past Accepting new patients

Locations

16542 Ventura Blvd
Ste 506
Encino, CA 91436
Phone (818) 943-8228

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1585872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1902435779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4909 AUBURN AVE APT 1103",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208142839",
            "telephone_number": "818-793-6219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5530 WISCONSIN AVE STE 1230",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208154301",
            "telephone_number": "301-962-2166"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16542 Ventura Blvd Ste 506",
            "address_purpose": "LOCATION",
            "city": "Encino",
            "state": "CA",
            "postal_code": "914364577",
            "country_code": "US",
            "telephone_number": "818-943-8228",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2515 Eastbluff Dr",
            "address_purpose": "LOCATION",
            "city": "Newport Beach",
            "state": "CA",
            "postal_code": "926603504",
            "country_code": "US",
            "telephone_number": "949-640-5050",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10833 Le Conte Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900953075",
            "country_code": "US",
            "telephone_number": "310-825-9789",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "KAITLIN",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-03",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "105504",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MD",
            "license": "18935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chevy Chase, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2025; 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.