Healthcare Provider Details

I. General information

NPI: 1700943883
Provider Name (Legal Business Name): ALPHONZO LOWELL DAVIDSON, SR SR. DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9470 ANNAPOLIS ROAD #303 LANHAM MARYLAND 20706
LANHAM MD
20706
US

IV. Provider business mailing address

9470 ANNAPOLIS ROAD #303 LANHAM MARYLAND 20706
LANHAM MD
20706
US

V. Phone/Fax

Practice location:
  • Phone: 301-322-8900
  • Fax: 301-322-2840
Mailing address:
  • Phone: 301-322-8900
  • Fax: 301-322-2840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number5342
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License NumberMD5342
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDEN2524
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: