Individual provider Active NPI

David Michael Devito, D.M.D.

  • General Practice Dentistry
  • Lexington, KY
National Provider Identifier
1124409487
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9598 Issued in KY
Practice address
800 Rose Street, RM. D104
University of Kentucky College of Dentistry
Lexington, KY 40536-0297
Phone
(859) 323-3368
Fax
(859) 257-5859
NPI assigned
Jun 12, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 9598 KY Primary

Addresses

Primary practice location

800 Rose Street, RM. D104
University of Kentucky College of Dentistry
Lexington, KY 40536-0297

Mailing address

800 Rose Street, RM. D104
University of Kentucky College of Dentistry
Lexington, KY 40536-0297
Phone (859) 323-3368

Other practice location 1

2195 Harrodsburg Road, Suite 175
UK Oral Health
Lexington, KY 40504-3504
Phone (859) 323-8873

Other identifiers 1

IdentifierTypeStateIssuer
7100434250MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170818001671 KY Practitioner - Dentist 6103101514 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9598KYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
University of Kentucky General Practice CurrentSince Sep 1, 2017 Accepting new patients
University of Kentucky CurrentSince Sep 1, 2017 Accepting new patients

Locations

800 Rose St
Rm D104
Lexington, KY 40536
Phone (859) 323-5831

770 Rose St
Lexington, KY 40536
Phone (859) 323-3368

800 Rose St
Rm D141
Lexington, KY 40536

Interoperability endpoints

  • Direct secure messaging: ddevito15374@ukhcdirect.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1434067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1124409487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 ROSE STREET, RM. D104",
            "address_2": "UNIVERSITY OF KENTUCKY COLLEGE OF DENTISTRY",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405360297",
            "telephone_number": "859-323-3368",
            "fax_number": "859-257-5859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 ROSE STREET, RM. D104",
            "address_2": "UNIVERSITY OF KENTUCKY COLLEGE OF DENTISTRY",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405360297",
            "telephone_number": "859-323-3368",
            "fax_number": "859-257-5859"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2195 Harrodsburg Road, Suite 175",
            "address_2": "UK Oral Health",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405043504",
            "country_code": "US",
            "telephone_number": "859-323-8873",
            "fax_number": "859-323-7193",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEVITO",
        "first_name": "DAVID",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-12",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "9598",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100434250",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.