DR. GORDON BRUCE DAVIS M.D. D.D.S. NPI 1477641041

NPI Information

NPI: 1477641041
Provider Name: DR. GORDON BRUCE DAVIS, M.D., D.D.S.
Classification: Dentist - 1223S0112X
Entity Type: Individual

Specialization: Oral and Maxillofacial Surgery

Address:
1111 PACIFIC AVE
STE 1
EVERETT, WA
ZIP 98201
Phone: (425) 348-1382
Get Directions

DR. Gordon Bruce Davis, M.D., D.D.S. is an oral and maxillofacial surgery dentist in Everett, WA. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. DR. Gordon Bruce Davis, M.D., D.D.S. NPI is 1477641041. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1111 PACIFIC AVE
STE 1
EVERETT, WA
ZIP 98201-200
Phone: (425) 348-1382
Fax: (425) 903-4402

The enumeration date for this NPI number is 10/10/2006 and was last updated on 5/5/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223S0112X	Dentist	Oral and Maxillofacial Surgery	4915	WASHINGTON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	21701	OTHER	CALIFORNIA	DENTAL LICENSE NUMBER
2	A09087	MEDICARE UPIN	WASHINGTON
3	G001200184	MEDICARE PIN	WASHINGTON
4	14666	OTHER	WASHINGTON	MD LICENSE NUMBER
5	5161	OTHER	WASHINGTON	WASHINGTON DENTAL SERVICE
6	DE00004915	OTHER	WASHINGTON	DENTAL LICENSE NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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