Gary C Davidson, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4222 Issued in OK

Practice address

122 E Chestnut St
Coweta, OK 74429

Phone

(918) 486-3266

Fax

(918) 486-5926

NPI assigned

Nov 13, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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 OK

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

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952472839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 E CHESTNUT ST",
            "city": "COWETA",
            "state": "OK",
            "postal_code": "74429",
            "telephone_number": "918-486-3266",
            "fax_number": "918-486-5926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 E CHESTNUT ST",
            "city": "COWETA",
            "state": "OK",
            "postal_code": "74429",
            "telephone_number": "918-486-3266",
            "fax_number": "918-486-5926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "GARY",
        "middle_name": "C",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "4222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Creek Nation Hospital & Clinics (Koweta Health Dietitans)
• Creek Nation Hospital & Clinics
• Creek Nation Hospital and Clinics (Koweta Indian Health Facility)
• Sidney Browning Daniel Jr., DPH
• Roxana Daniels
• Carl Davis
• Lisa C Davis, AS
• Christina Doss, M.S. CCC-SLP
• Dr. Jerry a. Nelms D.O.
• Robert Daryn Drake, O.D.

• General Practice Dentistry in Coweta, OK
• Providers in Coweta, OK by specialty
• General Practice Dentistry in Oklahoma

• 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.
• 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.