Dr. Dantae D Davies MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

G28898 Issued in CA

Legal business name

DR. DANTAE D DAVIES MD

Practice address

1189 Swallow LN Ste 201
Simi Valley, CA 93065-3157

Phone

(805) 577-7977

Fax

(805) 577-0745

NPI assigned

Apr 22, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Dantae D. Davies, M.D.NPI 1649351941

Title

President

Phone

(805) 577-7977

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dantae D. Davies, M.D.

  • Specialist
  • Simi Valley, CA
  • NPI 1649351941
  NPD Authorized official

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

{
    "created_epoch": "1177200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510185600000",
    "number": "1942428461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1189 SWALLOW LANE",
            "address_2": "SUITE 201",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930653157",
            "telephone_number": "805-577-7977",
            "fax_number": "805-577-0745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1189 SWALLOW LN STE 201",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930653157",
            "telephone_number": "805-577-7977",
            "fax_number": "805-577-0745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. DANTAE D DAVIES MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-22",
        "last_updated": "2017-11-09",
        "status": "A",
        "authorized_official_last_name": "DAVIES",
        "authorized_official_first_name": "DANTAE",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-577-7977",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G28898",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "CA",
            "license": "G28898",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G288980",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Simi Valley, CA
• Providers in Simi Valley, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2017; 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.