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Deactivated NPI 1134104599 Deactivated / Inactive NPI Male Practitioner

Dr. Robert Chester Davis , DMD MAGD

Dentist - General Practice • Pueblo, CO

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Robert Davis has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date December 08, 2005
NPI Deactivation Date April 09, 2026
Total Practice Duration ~21 Years of Practice (2005 – 2026)

Professional Overview & Biography Verified Profile Summary

Dr. Robert Davis, DMD MAGD was a registered Dentist - General Practice practicing in Pueblo, CO. Throughout an active medical career spanning 21 years, Dr. Davis provided care at the practice location at 902 W 29TH ST until profile deactivation on 2026-04-09.

Practice Location & Contact Primary Location

Practice Address

902 W 29th St

Pueblo, CO 81008

Telephone 7195425300
Fax 7195455525
Associated Practice Facility / Clinic
🏢 Timothy G. Bourdon, Dds, Llc Facility NPI 1356558845

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Pueblo, CO

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 18.5 Yrs
Regional Practice Density
67 Specialists

Practicing in Pueblo, CO (2613 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License CO 3556

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
Dr. Joseph Wohlwend , DDS

Dentist - General Practice

NPI 1255312906

Doctor of Dental Surgery

Dr. Charles Wohlwend , DDS

Dentist - General Practice

NPI 1366423279

Doctor of Dental Surgery

Janice Teuber

Dental Hygienist

NPI 1699154104

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated April 09, 2026

Record deactivated on April 09, 2026

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 902 W 29TH ST, PUEBLO, CO 81008 (Tel: 7195425300)

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Updated Business Mailing Address July 08, 2007

Registered at 902 W 29TH ST, PUEBLO, CO 81008 (Tel: 7195425300)

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Provider Name / Credentials Updated July 08, 2007

Recorded as ROBERT DAVIS, DMD MAGD

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #3556 in CO)

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Initial NPI Registration & Enumeration December 08, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1134104599
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 08, 2005
Last Update: July 08, 2007
Deactivation Date: April 09, 2026

Mailing Address

902 W 29th St

Pueblo, CO 81008

Phone: 7195425300

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.