Amanda Davis, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

6080 Issued in AL

Practice address

1555 Pelham Rd S Ste G
Jacksonville, AL 36265-3377

Phone

(256) 371-0310

NPI assigned

Mar 12, 2014

Sex

Female

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Amanda Davis, DMD, LLC

  • Dental Clinic/Center
  • Jacksonville, AL
  • NPI 1447713169
  NPD (past) Authorized official
• Timothy W Smith DMD LLC

  • Dental Clinic/Center
  • Hanceville, AL
  • NPI 1508103821
  NPD (past)

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

{
    "created_epoch": "1394582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554768000000",
    "number": "1982020152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 OXMOOR GLEN CIR",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352116448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 PELHAM RD S STE G",
            "city": "JACKSONVILLE",
            "state": "AL",
            "postal_code": "362653377",
            "telephone_number": "256-371-0310"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "655 Al Highway 69 S",
            "address_purpose": "LOCATION",
            "city": "Hanceville",
            "state": "AL",
            "postal_code": "350773405",
            "country_code": "US",
            "telephone_number": "256-287-1250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "AMANDA",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-12",
        "last_updated": "2019-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "6080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• T. David Cunningham Jr., LPC; NBCC
• Chandler Shannon Cupp
• Krystin Paige Cuthrell, LPC
• Dakota B Clark DMD LLC
• David G. Chandler, O.D.,P.C.
• Shawna Davis
• Bethany A Dean-Stoots
• Doctors Med Care of Jacksonville, P.C.
• Dr Muhamad Mazen Festok
• Drayer Physical Therapy-Alabama, LLC

• Dentist in Jacksonville, AL
• Providers in Jacksonville, AL by specialty
• Dentist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2019; 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.