GORDON B DAVIS MD DDS PS (NPI# 1073826996) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073826996 |
| Entity Type | Organization |
| Organization Name | GORDON B DAVIS MD DDS PS |
| Practice Address |
1111 Pacific Ave Suite A Everett WA 98201-4200 |
| Mailing Address |
9810 Marine View Dr Mukilteo WA 98275-4110 |
| Practice Telephone | 4252589586 |
| Practice Fax Number | 4252591486 |
| Mailing Telephone | 4253481382 |
| Mailing Fax Number | 4259034402 |
| Enumeration Date | 2010-07-20 |
| Last Update Date | 2016-05-05 |
| Authorized Official Name | MR. GORDON BRUCE DAVIS (PRESIDENT) |
| Authorized Official Telephone | 4253481382 |
| Authorized Official Credential | MD DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
WA | Dental Providers |
| Street Address |
1111 PACIFIC AVE SUITE A |
| City | EVERETT |
| State | WA |
| Zip Code | 98201-4200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720021140 | Thomas P Cooper | Urology | 1111 Pacific Ave, Everett, WA 98201-4200 | 2006-06-14 |
| 1952512329 | Hooman Hajian | Internal Medicine | 1111 Pacific Ave, Suite B, Everett, WA 98201-4200 | 2007-05-25 |
| 1477641041 | Gordon Bruce Davis | Dentist | 1111 Pacific Ave, Ste 1, Everett, WA 98201-4200 | 2006-10-10 |
| 1114031655 | Chia-jen Kuan | Internal Medicine | 1111 Pacific Ave, Suite B, Everett, WA 98201-4032 | 2006-08-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306471867 | Shannon Michelle Dewald | Registered Nurse | D8s 1700 13th St, Everett, WA 98201 | 2020-03-05 |
| 1578123113 | Precious Medicial Spa, LLC | Registered Nurse | 1728 W. Marine View Dr Suite 212, Everett, WA 98201 | 2019-06-17 |
| 1508429796 | Alix Deschain | Counselor | 2801 Broadway, Everett, WA 98201 | 2019-04-15 |
| 1811457534 | Khushboo Patel | Pharmacist | 1330 Rockefeller Ave Ste 150, Everett, WA 98201 | 2019-03-20 |
| 1164991188 | Grace Talbot Davis | Registered Nurse | 2601 Summit Avenue, Bldg. C, Everett, WA 98201 | 2018-11-20 |
| 1063924603 | Tracy Sisk | Counselor | 3120 Colby Ave, 502, Everett, WA 98201 | 2017-11-03 |
| 1710403126 | Michelle Durham | Counselor | 3322 Boadway Fl 2, Everett, WA 98201 | 2017-08-17 |
| 1861927949 | Melanie Schmidt | Counselor | 2610 Westmore Ave, Everett, WA 98201 | 2017-04-26 |
| 1518413327 | Joseph Madson Dmd Pllc | Clinic/Center | 3802 Colby Ave, 4th Floor, Everett, WA 98201 | 2016-08-31 |
| 1043683162 | Jennifer Adams | Counselor | 1511 26th St, Everett, WA 98201 | 2015-11-11 |
| Find all providers in zip 98201 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes 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. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104396969 | Mark Stivers, Dds, Inc., P.s. | Dentist | 12728 19th Ave Se Ste 101, Everett, WA 98208-6526 | 2018-12-04 |
| 1932496809 | Marc J Toso | Dentist | 5929 Evergreen Way Ste 300, Everett, WA 98203 | 2011-06-29 |
| 1710906300 | Christopher Michael Lance | Dentist | 138 Memorial Dr, Everett, PA 15537-7028 | 2006-07-18 |
| 1316946437 | Mark W Stivers | Dentist | 12728 19th Ave Se # 101, Everett, WA 98208 | 2005-07-20 |
| 1184944001 | Washingtonoralmaxillofacialsurgery | Dentist | 5929 Evergreen Way, 300, Everett, WA 98203-6031 | 2010-06-02 |
| 1770787442 | Paul E Tesone Dds Inc | Dentist | 563 Broadway, Suite 4, Everett, MA 02149 | 2007-06-14 |
| 1184779977 | Paul Edward Tesone | Dentist | 563 Broadway, #4, Everett, MA 02149 | 2007-01-24 |
| 1477641041 | Gordon Bruce Davis | Dentist | 1111 Pacific Ave, Ste 1, Everett, WA 98201-4200 | 2006-10-10 |
| 1538257308 | Jae Y Hong | Dentist | 5929 Evergreen Way, # 300, Everett, WA 98203-6031 | 2006-10-10 |
| 1972522530 | Gregory Wynn Pyle | Dentist | 138 Memorial Dr, Everett, PA 15537-7028 | 2006-07-18 |
| Find all providers in EVERETT | ||||
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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.