MEDICARE: DR. MAYNARD DAVENPORT D.D.S.

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	D1086	AZ

General Provider Information

NPI Number	:	1700832458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MAYNARD DAVENPORT D.D.S.

Provider Business Mailing Address
First Line	:	PO BOX 368
Second Line	:
City	:	PINETOP
State	:	AZ
Zip	:	85935-0368
Country	:	US
Telephone Number	:	928-367-3543
Fax Number	:	928-367-2084

Provider Business Practice Location Address
First Line	:	43 W WHITE MOUNTAIN BLVD
Second Line	:
City	:	PINETOP
State	:	AZ
Zip	:	85935-7060
Country	:	US
Telephone Number	:	928-367-3543
Fax Number	:	928-367-2084

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

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	07/08/2007

Similar Medicare Providers

1821075524 — DR. RICHARD ALBERT BOATRIGHT DC
Practice Location Address:

43 W WHITE MOUNTAIN BLVD , SUITE C
PINETOP, AZ
85935-7060

Practice Phone: 928-367-4402
Practice Fax: 928-367-4403

1356279996 — CODE CALM COUNSELING PLLC
Practice Location Address:

759 E WHITE MOUNTAIN BLVD
PINETOP, AZ
85935-7098

Practice Phone: 928-242-0920
Practice Fax:

1104753078 — AMARE INTEGRATED CLINICAL SERVICES, LLC
Practice Location Address:

6856 BUCK SPRINGS RD
PINETOP, AZ
85935-0500

Practice Phone: 928-940-2120
Practice Fax:

1194721977 — TIMBERLINE MEDICAL SUPPLY
Practice Location Address:

674 E WHITE MOUNTAIN BLVD
PINETOP, AZ
85935-7064

Practice Phone: 928-367-6834
Practice Fax: 928-367-6838

1477541043 — ROBERT FLAKE DPM
Practice Location Address:

728 E WHITE MOUNTAIN BLVD , SUITE C
PINETOP, AZ
85935-7027

Practice Phone: 928-367-3701
Practice Fax: 928-367-0801

1386625457 — ALPHA OXY-MED LLC
Practice Location Address:

674 E WHITE MOUNTAIN BLVD , SUITE 3
PINETOP, AZ
85935

Practice Phone: 928-367-7415
Practice Fax: 928-367-7416

Directions to “ DR. MAYNARD DAVENPORT D.D.S.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.