Healthcare Provider Details

I. General information

NPI: 1891062915
Provider Name (Legal Business Name): GERALD DAVIS II D.D.S., M.A., M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2011
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 24TH AVE S
NASHVILLE TN
37212-2637
US

IV. Provider business mailing address

PO BOX 330295
NASHVILLE TN
37203-7502
US

V. Phone/Fax

Practice location:
  • Phone: 615-873-7120
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number0000009543
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code1223X2210X
TaxonomyOrofacial Pain Dentistry
License NumberDS0000009543
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: