Active NPI
Gary L Devian, D.D.S.
- Orthodontics and Dentofacial Orthopedics Dentistry
- Yorba Linda, CA
National Provider Identifier
1063641256
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 30620
- Practice address
- 17300 Yorba Linda Blvd
Suite K
Yorba Linda, CA 92886-3810 - Phone
- (714) 524-6111
- Fax
- (714) 985-0256
- NPI assigned
- Jul 8, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 30620 | CA | Primary |
Addresses
Primary practice location
17300 Yorba Linda Blvd
Suite K
Yorba Linda, CA 92886-3810
Mailing address
17300 Yorba Linda Blvd
Suite K
Yorba Linda, CA 92886-3810
Phone (714) 524-6111
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30620 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247011200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1247011200000",
"number": "1063641256",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17300 YORBA LINDA BLVD",
"address_2": "SUITE K",
"city": "YORBA LINDA",
"state": "CA",
"postal_code": "928863810",
"telephone_number": "714-524-6111",
"fax_number": "714-985-0256"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17300 YORBA LINDA BLVD",
"address_2": "SUITE K",
"city": "YORBA LINDA",
"state": "CA",
"postal_code": "928863810",
"telephone_number": "714-524-6111",
"fax_number": "714-985-0256"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEVIAN",
"first_name": "GARY",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-07-08",
"last_updated": "2009-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "CA",
"license": "30620",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yorba Linda, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.