Active NPI
Alex D Devigal, D.D.S.
- General Practice Dentistry
- Berkeley, CA
National Provider Identifier
1083749048
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 42144
- Practice address
- 917 The Alameda
Berkeley, CA 94707-2301 - Phone
- (510) 525-2266
- Fax
- (510) 525-9429
- NPI assigned
- Feb 22, 2007
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 42144 | IL | Primary |
Addresses
Primary practice location
917 The Alameda
Berkeley, CA 94707-2301
Mailing address
137 Flying Dutchman CT
Vallejo, CA 94591-7726
Phone (707) 554-0337
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 |
|---|---|---|---|
| 42144 | IL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204588800000",
"number": "1083749048",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "137 FLYING DUTCHMAN CT",
"city": "VALLEJO",
"state": "CA",
"postal_code": "945917726",
"telephone_number": "707-554-0337"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "917 THE ALAMEDA",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947072301",
"telephone_number": "510-525-2266",
"fax_number": "510-525-9429"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEVIGAL",
"first_name": "ALEX",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-22",
"last_updated": "2008-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": "42144",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Berkeley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.