Devin Kyle Giron, DDS

Individual provider Active NPI General Practice Dentistry · Isleta, NM

NPI 1134433865 · NPPES record last updated Feb 24, 2012

Key facts

NPI
1134433865
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
DD3314 (NM)
Practice address
01 Sagebrush Street
Isleta, NM 87022-0640
Phone
(506) 869-3200
Fax
(505) 869-4881
NPI assigned
Aug 5, 2010
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20160208000784 TX Order and Referring Only - Dentist
Practitioner - Dentist
1759685076

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
DD3314NMMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DD3314 NM Yes

Addresses

Primary practice location

01 Sagebrush Street
Isleta, NM 87022-0640

Mailing address

P.O Box 640
Isleta, NM 87022-0640
Phone (505) 869-3200

Other identifiers

IdentifierTypeStateIssuer
95886061MedicaidNM

Other names

  • Dr. Devin Kyle Giron Other name

Other providers in Isleta, NM

All providers in Isleta, NM · General Practice Dentistry in New Mexico

Sources for this page

Verify at the official NPI Registry.