Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dustin Michael Davis, DDS

Individual provider Dentist · NPI 1063787497

Dustin Michael Davis, DDS is a Dentist in Clackamas, Oregon. Licensed in Colorado, Illinois, Oregon and Washington. Registered with an NPI since 2012.

Licensed in
CO, IL, OR, WA
In the registry since
2012
Specialties on file
4
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

11411 SE Sunnyside Rd Ste 101
Clackamas, OR 97015-9356
Phone: (503) 855-5100
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Dentistry (primary) Taxonomy 1223P0221X · Licence D11447 (OR)
Dentist Taxonomy 122300000X · Licence DEN.00202313 (CO)
Pediatric Dentistry Taxonomy 1223P0221X · Licence DE60650351 (WA)
Dentist Taxonomy 122300000X · Licence 019029333 (IL)

Record details

NPI number1063787497
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorNo
NPI enumeratedMarch 19, 2012
Last updated in NPPESJune 30, 2021
Certification dateJune 30, 2021
Mailing address11411 Se Sunnyside Rd Ste 101, Clackamas, OR 97015-9356

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