Provider Demographics
NPI:1861791873
Name:DAVENPORT, DENTON RYAN (DO)
Entity type:Individual
Prefix:DR
First Name:DENTON
Middle Name:RYAN
Last Name:DAVENPORT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16700 N THOMPSON PEAK PKWY STE 170
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-2386
Mailing Address - Country:US
Mailing Address - Phone:602-475-5646
Mailing Address - Fax:480-750-7119
Practice Address - Street 1:16700 N THOMPSON PEAK PKWY STE 170
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-2386
Practice Address - Country:US
Practice Address - Phone:602-475-5646
Practice Address - Fax:480-750-7119
Is Sole Proprietor?:No
Enumeration Date:2011-03-17
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ006600207LP2900X
OH34.011177207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology