Dr Jack Allen Davidson Jr, DDS, MD is a
Dentist - Oral And Maxillofacial Surgery physician based in Lithia, Florida. Dr Jack Allen Davidson Jr is licensed to practice in Maryland (license number 10794) and his current practice location is 16141 Fishhawk Blvd Ste B, Lithia, Florida. He can be reached at his office (for appointments etc.) via phone at
(813) 571-1516.
NPI number for Dr Jack Allen Davidson Jr is 1831289099 and his current mailing address is 16141 Fishhawk Blvd Ste B, Lithia, Florida. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1831289099.
Physician's Profile
| Full Name | Dr Jack Allen Davidson Jr |
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| Gender | Male |
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| Speciality | Dentist - Oral And Maxillofacial Surgery |
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| Location | 16141 Fishhawk Blvd Ste B, Lithia, Florida |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1831289099
- Provider Enumeration Date: 10/16/2006
- Last Update Date: 07/09/2025
Medical Identifiers
Medical identifiers for Dr Jack Allen Davidson Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1831289099 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208200000X | Plastic Surgery | ME72794 (Florida) | Secondary |
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 10794 (Maryland) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Jack Allen Davidson Jr is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Jack Allen Davidson Jr, DDS, MD
16141 Fishhawk Blvd Ste B,
Lithia, FL 33547-4380
Ph: (813) 571-1516 | Dr Jack Allen Davidson Jr, DDS, MD
16141 Fishhawk Blvd Ste B,
Lithia, FL 33547-4380
Ph: (813) 571-1516 |
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