Brian Devers, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

58764 Issued in CA

Practice address

315 Walnut Ave
San Diego, CA 92103-4904

Phone

(619) 297-2954

NPI assigned

Oct 28, 2010

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 8, 2018 through Oct 8, 2026

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ma and Bierman Dental Partnership

  • General Practice Dentistry
  • San Diego, CA
  • NPI 1720536857
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1288224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334707200000",
    "number": "1104126879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 WALNUT AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921034904",
            "telephone_number": "619-297-2954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 WALNUT AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921034904",
            "telephone_number": "619-297-2954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVERS",
        "first_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-10-28",
        "last_updated": "2012-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "58764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gina Devencenzi
• Joyce Devera
• Kathryn Devera, OTR/L
• Erin Deveraux
• Michael C Devereaux, MD
• Carolyn Devers
• Corinne Cekeste Devin, DMD
• Anne M Devine, OD
• Kristina H Devine, FNP
• Maura Keely Devine, MD

• General Practice Dentistry in San Diego, CA
• Providers in San Diego, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.