# DUSTIN MICHAEL DAVIS

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1063787497
- **Gender:** Man
- **Credential:** D.D.S.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 019029333 | IL | — |
| 122300000X | Dentist | DEN.00202313 | CO | — |
| 1223P0221X | Pediatric Dentistry | D11447 | OR | Yes |
| 1223P0221X | Pediatric Dentistry | DE60650351 | WA | — |

## Other

- **Enumeration date:** 03/19/2012
- **Last updated:** 06/30/2021