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

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

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.

• PKR Dental LLC

  • 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
• 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.