Active NPI
Bret C Davis, DMD
- Dentist
- Sugar Land, TX
National Provider Identifier
1992714489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 27714
- Practice address
- 4665 Sweetwater Blvd Ste 450
Sugar Land, TX 77479-3155 - Phone
- (281) 265-7645
- NPI assigned
- Aug 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 27714 | TX | Primary |
| Dental Assistant | 126800000X | D3668 | ID |
Addresses
Primary practice location
4665 Sweetwater Blvd Ste 450
Sugar Land, TX 77479-3155
Mailing address
4665 Sweetwater Blvd Ste 450
Sugar Land, TX 77479-3155
Phone (281) 265-7645
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100508089 | Medicaid | NV | |
| 806617800 | Medicaid | ID |
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 |
|---|---|---|---|
| 27714 | TX | MD | Dentist |
| D3668 | ID | MD | Dental Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617840000000",
"number": "1992714489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4665 SWEETWATER BLVD STE 450",
"city": "SUGAR LAND",
"state": "TX",
"postal_code": "774793155",
"telephone_number": "281-265-7645"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4665 SWEETWATER BLVD STE 450",
"city": "SUGAR LAND",
"state": "TX",
"postal_code": "774793155",
"telephone_number": "281-265-7645"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "BRET",
"middle_name": "C",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-05",
"last_updated": "2021-04-08",
"certification_date": "2021-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "27714",
"primary": true
},
{
"code": "126800000X",
"taxonomy_group": "",
"desc": "Dental Assistant",
"state": "ID",
"license": "D3668",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100508089",
"state": "NV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "806617800",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sugar Land, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.