Healthcare Provider Details

I. General information

NPI: 1477203586
Provider Name (Legal Business Name): STEVEN DAVIS DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2022
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 COURT SQ APT 2604
LONG ISLAND CITY NY
11101-8934
US

IV. Provider business mailing address

3 COURT SQ APT 2604
LONG ISLAND CITY NY
11101-8934
US

V. Phone/Fax

Practice location:
  • Phone: 917-635-3091
  • Fax:
Mailing address:
  • Phone: 917-635-3091
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number063108
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: