Provider Demographics
NPI:1336390848
Name:DAVIDSON, MONICA W (DDS)
Entity type:Individual
Prefix:DR
First Name:MONICA
Middle Name:W
Last Name:DAVIDSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:N
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:808 KIRKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37204-2602
Mailing Address - Country:US
Mailing Address - Phone:159-532-2469
Mailing Address - Fax:
Practice Address - Street 1:808 KIRKWOOD AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204-2602
Practice Address - Country:US
Practice Address - Phone:615-953-2469
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-02
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR36941223G0001X
GADN0140591223G0001X
TN117871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001051600Medicaid
AR188373608Medicaid