Ricky Lawrence Davison, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1114 Issued in NM

Practice address

7520 Montgomery Blvd NE
Suite E-4
Albuquerque, NM 87109-1521

Phone

(505) 883-6111

Fax

(505) 883-6101

NPI assigned

Aug 12, 2006

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

Enrolled in NM

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

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247184000000",
    "number": "1942212808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7520 MONTGOMERY BLVD NE",
            "address_2": "SUITE E-4",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871091521",
            "telephone_number": "505-883-6111",
            "fax_number": "505-883-6101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7520 MONTGOMERY BLVD NE",
            "address_2": "SUITE E-4",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871091521",
            "telephone_number": "505-883-6111",
            "fax_number": "505-883-6101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVISON",
        "first_name": "RICKY",
        "middle_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2009-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "1114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victor Hardwick Davis, MD
• Victoria Davis
• William Austin Davis
• Zachary Davis
• Amanda S Davison, LMFT
• Ronda Davison, RN
• Davita Medical Group New Mexico, LLC
• Kristin Dawe, CCHW
• Leah Dawit
• Angie D. Dawson, LCSW

• General Practice Dentistry in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• General Practice Dentistry in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2009; 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.