MEDICARE: DR. NNEKA NATASHA DAVIS D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry	12674	MD

General Provider Information

NPI Number	:	1184868184
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NNEKA NATASHA DAVIS D.M.D.

Provider Business Mailing Address
First Line	:	7230 LEE DEFOREST DR STE 107N
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21046-3202
Country	:	US
Telephone Number	:	443-622-8908
Fax Number	:

Provider Business Practice Location Address
First Line	:	7230 LEE DEFOREST DR STE 107N
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21046-3202
Country	:	US
Telephone Number	:	443-622-8908
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/22/2009
Last Update Date	:	02/26/2024

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