Alexis Delon Irby, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN015479 Issued in GA

Practice address

1450 Highway 138 SE
Conyers, GA 30013-1285

Phone

(770) 285-2270

NPI assigned

Jul 10, 2017

Last updated

Jul 10, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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

• PKR Dental LLC

  dba Aspen Dental

  • Dentist
  • Conyers, GA
  • NPI 1841656246
  NPD (past)

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

{
    "created_epoch": "1499644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499644800000",
    "number": "1124540224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3328 DESOTO RD",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300784159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 HIGHWAY 138 SE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300131285",
            "telephone_number": "770-285-2270"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1450 Highway 138 SE",
            "address_purpose": "LOCATION",
            "city": "Conyers",
            "state": "GA",
            "postal_code": "300131285",
            "country_code": "US",
            "telephone_number": "770-285-2270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IRBY",
        "first_name": "ALEXIS",
        "middle_name": "DELON",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-10",
        "last_updated": "2017-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN015479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Internal Medicine Associates of Rockdale PC
• International Medical Systems, LLC
• Interventional Spine and Pain Management Ambulatory Surgical Center
• Interventional Spine and Pain Management Center, PC (Alliance Spine and Pain Centers)
• Ips of Conyers LLC
• John Tucker Irwin
• Karen Stefani Isaacson, D.C.
• Adekemi Abosede Ishola, MD, MBA
• George Isshak, M.D.
• Jacek Lyszkowicz MD PC

• General Practice Dentistry in Conyers, GA
• Providers in Conyers, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.