Allen Glen Davis, D.D.S., M.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

29576 Issued in CA

Practice address

9420 Mira Mesa Blvd Ste J
San Diego, CA 92126-4848

Phone

(858) 578-5002

Fax

(858) 578-5832

NPI assigned

Jan 25, 2007

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902951056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9420 MIRA MESA BLVD STE J",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921264848",
            "telephone_number": "858-578-5002",
            "fax_number": "858-578-5832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9420 MIRA MESA BLVD STE J",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921264848",
            "telephone_number": "858-578-5002",
            "fax_number": "858-578-5832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ALLEN",
        "middle_name": "GLEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "29576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan M Davis-Crawford-Haggerty, AMFT
• Tiffany Alice Davis-Maltby, MD
• Jill Marie Davis-Prickett, NP
• Alberia Joseph Davis, MS
• Alicia D Davis
• Amanda Gayle Davis, M.S. CCC-SLP
• Angela Michelle Davis, M.S.,CCC-SLP
• Anne Ingrid Davis
• Arianna Davis
• Ashley Marie Davis

• Orthodontics and Dentofacial Orthopedics Dentistry in San Diego, CA
• Providers in San Diego, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.