Davidson Family Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D4322 Issued in ID

Legal business name

DAVIDSON FAMILY DENTAL

Practice address

509 W Hanley Ave Ste 201
Coeur D Alene, ID 83815-8994

Phone

(208) 667-5447

Fax

(208) 666-8918

NPI assigned

Nov 18, 2014

Organization subpart

No

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

Authorized official

Name

Kirk Michael Davidson, DDS

Title

Owner

Phone

(208) 667-5447

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1416268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416268800000",
    "number": "1922404987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 W HANLEY AVE STE 201",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838158994",
            "telephone_number": "208-667-5447",
            "fax_number": "208-666-8918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 W HANLEY AVE STE 201",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838158994",
            "telephone_number": "208-667-5447",
            "fax_number": "208-666-8918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVIDSON FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-18",
        "last_updated": "2014-11-18",
        "status": "A",
        "authorized_official_last_name": "DAVIDSON",
        "authorized_official_first_name": "KIRK",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-667-5447",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D4322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barbara A Daugharty, M.D.
• Cheryl Davee, PT
• David Aggen Inc.
• David H Schmitz-Binnall
• David M Saelens MPT
• Bryan L Davidson, MD
• Kirk Michael Davidson, DDS
• Rachel Rae Davidson, DDS
• Susan Davies
• Billie Jo Davis, PH.D., BCBA

• All providers in Coeur D Alene, ID
• General Practice Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2014; 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.