John Byrnside Davis, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

019276 Issued in WV

Practice address

Route 98 Medwood Plaza
Suite 302
Nutter Fort, WV 26301

Phone

(304) 622-5711

Fax

(304) 622-6001

NPI assigned

Oct 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1160784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962592386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ROUTE 98 MEDWOOD PLAZA",
            "address_2": "SUITE 302",
            "city": "NUTTER FORT",
            "state": "WV",
            "postal_code": "26301",
            "telephone_number": "304-622-5711",
            "fax_number": "304-622-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ROUTE 98 MEDWOOD PLAZA",
            "address_2": "SUITE 302",
            "city": "NUTTER FORT",
            "state": "WV",
            "postal_code": "26301",
            "telephone_number": "304-622-5711",
            "fax_number": "304-622-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JOHN",
        "middle_name": "BYRNSIDE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WV",
            "license": "3034",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WV",
            "license": "019276",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7800056000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Colev, M.D.
• Community Care of West Virginia, Inc.
• Community Care of West Virginia, Inc.
• Travis Allen Cottrill, RN
• Holly Crayton
• Benjamin Defazio
• Dr. Robert Martino, PLLC
• Krystal Elias
• Melissa Renae Eubank
• First Settlement Physical Therapy

• All providers in Nutter Fort, WV
• Dentist in West Virginia

• 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.

Verify at the official NPI Registry.