Provider Demographics
NPI:1285920801
Name:DAVIS, JOSHUA R (DDS)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:R
Last Name:DAVIS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 COLUMBUS AVE STE C
Mailing Address - Street 2:
Mailing Address - City:TUCKAHOE
Mailing Address - State:NY
Mailing Address - Zip Code:10707-2553
Mailing Address - Country:US
Mailing Address - Phone:914-533-4200
Mailing Address - Fax:914-533-4202
Practice Address - Street 1:300 COLUMBUS AVE STE C
Practice Address - Street 2:
Practice Address - City:TUCKAHOE
Practice Address - State:NY
Practice Address - Zip Code:10707-2553
Practice Address - Country:US
Practice Address - Phone:914-522-4200
Practice Address - Fax:914-533-4200
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0560901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice