NPIMap

Organization Active NPI

Costes Davis, DDS Dental Practice

Doing business as Hall Of Fame Dental

  • General Practice Dentistry
  • Bakersfield, CA
National Provider Identifier
1922457746
Registry record updated Jun 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6359 Issued in CA
Legal business name
COSTES DAVIS, DDS DENTAL PRACTICE
Doing business as
Hall Of Fame Dental
Practice address
3015 Calloway Dr Unit 14
Bakersfield, CA 93312-2659
Phone
(661) 587-6453
NPI assigned
Jun 13, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2016

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

Authorized official

Name
Kelcie Dee Thompson
Title
Billing/Insurance Manager
Phone
(928) 925-6522

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 6359 CA Primary

Addresses

Primary practice location

3015 Calloway Dr Unit 14
Bakersfield, CA 93312-2659

Mailing address

3015 Calloway Dr Unit 14
Bakersfield, CA 93312-2659
Phone (661) 587-6453

Other names 1

  • Hall Of Fame Dental Doing business as

National Provider Directory

National Provider Directory

Locations

3015 Calloway Dr
Ste 14
Bakersfield, CA 93312
Phone (661) 587-6453

NPI Registry JSON

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

{
    "created_epoch": "1465776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465776000000",
    "number": "1922457746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 CALLOWAY DR UNIT 14",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933122659",
            "telephone_number": "661-587-6453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 CALLOWAY DR UNIT 14",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933122659",
            "telephone_number": "661-587-6453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COSTES DAVIS, DDS DENTAL PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-13",
        "last_updated": "2016-06-13",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "KELCIE",
        "authorized_official_middle_name": "DEE",
        "authorized_official_title_or_position": "BILLING/INSURANCE MANAGER",
        "authorized_official_telephone_number": "928-925-6522"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "6359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hall Of Fame Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bakersfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2016; 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.