MEDICARE: DOCTORS BILL AND DAVIS DENTISTRY, PLLC

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	S3-233	NV
2	1223P0221X	Pediatric Dentistry	S6-121	NV

General Provider Information

NPI Number	:	1548607294
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOCTORS BILL AND DAVIS DENTISTRY, PLLC

Provider Business Mailing Address
First Line	:	10660 SOUTHERN HIGHLANDS PKWY
Second Line	:	SUITE #110
City	:	LAS VEGAS
State	:	NV
Zip	:	89141-4114
Country	:	US
Telephone Number	:	702-477-0040
Fax Number	:

Provider Business Practice Location Address
First Line	:	10660 SOUTHERN HIGHLANDS PKWY
Second Line	:	SUITE 110
City	:	LAS VEGAS
State	:	NV
Zip	:	89141-4114
Country	:	US
Telephone Number	:	702-477-0040
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	JAY E DAVIS
Credential	:	DMD, MS
Telephone Number	:	702-477-0040

Provider Enumeration Date	:	06/03/2013
Last Update Date	:	05/17/2022

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