Active NPI
Timothy L. Davis, D.D.S.
- General Practice Dentistry
- Cozad, NE
National Provider Identifier
1952491607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 6613
- Practice address
- 1002 Meridian Ave
Cozad, NE 69130-1757 - Phone
- (308) 784-3377
- NPI assigned
- Oct 13, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 6613 | NE | Primary |
Addresses
Primary practice location
1002 Meridian Ave
Cozad, NE 69130-1757
Mailing address
PO Box 248
Cozad, NE 69130-0248
Phone (308) 784-3377
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10025385300 | Medicaid | NE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6613 | NE | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Davis Family Dental, LLC | Past | Accepting new patients | |
| Amber Ide DDS, LLC | General Practice | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Dental Clinic/Center
- Cozad, NE
- NPI 1437296225
-
- General Practice Dentistry
- Cozad, NE
- NPI 1750950937
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1952491607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 248",
"city": "COZAD",
"state": "NE",
"postal_code": "691300248",
"telephone_number": "308-784-3377"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1002 MERIDIAN AVE",
"city": "COZAD",
"state": "NE",
"postal_code": "691301757",
"telephone_number": "308-784-3377"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "TIMOTHY",
"middle_name": "L.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NE",
"license": "6613",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10025385300",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cozad, NE
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.