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NPI Code Detail

MEDICARE: DR. RICHARD GORDON DAVIS D.D.S.

MEDICARE:  DR. RICHARD GORDON DAVIS  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
11223S0112XOral and Maxillofacial Surgery (Dentist)30-014057OH

General Provider Information

NPI Number : 1821193756
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RICHARD GORDON DAVIS D.D.S.
Provider Business Mailing Address
First Line : 10701 EAST BLVD
Second Line : 160(W)
City : CLEVELAND
State : OH
Zip : 44106-1702
Country : US
Telephone Number : 216-791-3800
Fax Number : 216-421-3043
Provider Business Practice Location Address
First Line : 10701 EAST BLVD
Second Line : 160(W)
City : CLEVELAND
State : OH
Zip : 44106-1702
Country : US
Telephone Number : 216-791-3800
Fax Number : 216-421-3043
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2006
Last Update Date : 03/08/2026

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Directions to “ DR. RICHARD GORDON DAVIS D.D.S.” Practice Location

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