JOHN PHILIP MCKENZIE DAVIS (NPI# 1013490218) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013490218 |
| Entity Type | Individual |
| Full Name | JOHN PHILIP MCKENZIE DAVIS |
| Credential | DDS |
| Practice Address |
4100 W 28th Ave Pine Bluff AR 71603-4726 |
| Practice Telephone | 8708794870 |
| Mailing Telephone | 8708794870 |
| Enumeration Date | 2018-09-13 |
| Last Update Date | 2018-09-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 4306 | AR | Dental Providers |
| Street Address |
4100 W 28TH AVE |
| City | PINE BLUFF |
| State | AR |
| Zip Code | 71603-4726 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639396807 | Drew William Toole | Dentist | 4100 W 28th Ave, Pine Bluff, AR 71603-4726 | 2007-04-19 |
| 1740695576 | Drew Toole, D.d.s., P. A. | Preferred Provider Organization | 4100 W 28th Ave, Pine Bluff, AR 71603-4726 | 2014-07-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700445038 | Hannah Carter | Dentist | 3801 S Olive St, Pine Bluff, AR 71603 | 2019-06-11 |
| 1821544628 | Nauman Yunus Md Pa | Internal Medicine | 1600 West 40th Ave, Jefferson Regional Medical Center, Pine Bluff, AR 71603 | 2016-08-31 |
| 1407278120 | Arkansas Cancer Clinic Pa | Radiology | 7200 South Hazel Street, Pine Bluff, AR 71603 | 2014-01-15 |
| 1730515396 | Sharon Yvette Webb | Student in an Organized Health Care Education/Training Program | 2318 Kyle Street, Pine Bluff, AR 71603 | 2013-09-16 |
| 1477992733 | David Larry Byrd | Pharmacist | 5 Longmeadow, Pine Bluff, AR 71603 | 2013-06-20 |
| 1437400371 | Thomas Jordan Harper | Pharmacist | 2809 South Camden Road, Pine Bluff, AR 71603 | 2012-10-01 |
| 1992080469 | C&d Disability.inc | Early Intervention Provider Agency | 4806 W 9th Street, Pine Bluff, AR 71603 | 2011-10-17 |
| 1457645863 | Clifton G Roaf & Marvin Q Caudle | Dentist | 1310 South Linden Street, Pine Bluff, AR 71603 | 2011-06-02 |
| 1932402682 | Mary Campbell | Licensed Practical Nurse | 2302 W. 28th, Suite A, Pine Bluff, AR 71603 | 2010-12-17 |
| 1245468925 | Evan N Newbolt | Ophthalmology | 3805 West 28th Ave, Pine Bluff, AR 71603 | 2009-07-01 |
| Find all providers in zip 71603 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457805376 | Brent Herring | Dentist | 3721 S Olive St Ste B, Pine Bluff, AR 71603-6756 | 2016-08-09 |
| 1588927941 | David Keith Jones | Dentist | 1301 Ridgway Rd Ste 2b, Pine Bluff, AR 71603-7608 | 2012-06-20 |
| 1457645863 | Clifton G Roaf & Marvin Q Caudle | Dentist | 1310 South Linden Street, Pine Bluff, AR 71603 | 2011-06-02 |
| 1639396807 | Drew William Toole | Dentist | 4100 W 28th Ave, Pine Bluff, AR 71603-4726 | 2007-04-19 |
| 1467559971 | Marvin Quincy Caudle | Dentist | 1310 South Linden St, Pine Bluff, AR 71603 | 2006-09-19 |
| 1881700995 | Joel F. Foster | Dentist | 1400 W 42nd Ave, Pine Bluff, AR 71603-7003 | 2006-08-22 |
| 1013576933 | Garrett Taylor, Dds, Pa | Dentist | 3801 S Olive St, Pine Bluff, AR 71603 | 2019-06-13 |
| 1841762200 | Abdullah Sufian Elassouli | Dentist | 1400 W 42nd Ave, Pine Bluff, AR 71603-7003 | 2018-12-26 |
| 1023277746 | Jefferson Comprehensive Care System Inc | Dentist | 1101 Tennessee St, Pine Bluff, AR 71601-5801 | 2008-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235743352 | Varsha Patel | Dentist | 130 Harkrider St, Conway, AR 72032-6623 | 2020-09-04 |
| 1174132914 | John S Teed | Dentist | 800 Vista Cv, Marion, AR 72364-9704 | 2020-07-28 |
| 1891303509 | Brandt Thomas Cooper | Dentist | 1685 Airport Rd, Hot Springs, AR 71913-7951 | 2020-07-20 |
| 1174141667 | Anslee Latourette | Dentist | 8239 Rogers Ave, Fort Smith, AR 72903-5553 | 2020-07-10 |
| 1073139960 | Leona C. Kemper, Dds, Pa | Dentist | 6189 Heber Springs Rd West, Quitman, AR 72131 | 2020-06-17 |
| 1225652670 | David Barry Riggs | Dentist | 800 Locust Ave, Conway, AR 72034-5331 | 2020-06-02 |
| 1497378137 | Evgeny Titov | Dentist | 2501 Market Trce Ste A, Fort Smith, AR 72908-8881 | 2020-05-28 |
| 1306469382 | Phipps Family Dentistry | Dentist | 807 W Centerton Blvd, Centerton, AR 72719-9705 | 2020-05-25 |
| 1831711910 | Brian Lane D D S Pa | Dentist | 17 Eagle Park Dr, Vilonia, AR 72173-9050 | 2020-05-12 |
| 1215557897 | Wh Ar Dental Pllc | Dentist | 4870 Elm Springs Rd Ste B, Springdale, AR 72762-3749 | 2020-04-23 |
| Find all providers with the same taxonomy | ||||
| City | PINE BLUFF |
| Zip Code | 71603 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.