Active NPI
Devon Elise McClurg, DMD
- General Practice Dentistry
- Burleson, TX
National Provider Identifier
1205497682
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 35280
- Practice address
- 185 NW John Jones Dr Ste 600
Burleson, TX 76028-8043 - Phone
- (817) 295-8884
- NPI assigned
- Jun 26, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 35280 | TX | Primary |
Addresses
Primary practice location
185 NW John Jones Dr Ste 600
Burleson, TX 76028-8043
Mailing address
3001 Crockett St Apt 1703
Fort Worth, TX 76107-3293
Phone (720) 345-2343
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191015000189 | TX | Order and Referring Only - Dentist | 9537490008 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35280 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561507200000",
"number": "1205497682",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3001 CROCKETT ST APT 1703",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761073293",
"telephone_number": "720-345-2343"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "185 NW JOHN JONES DR STE 600",
"city": "BURLESON",
"state": "TX",
"postal_code": "760288043",
"telephone_number": "817-295-8884"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCLURG",
"first_name": "DEVON",
"middle_name": "ELISE",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-06-26",
"last_updated": "2019-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "35280",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burleson, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2019; 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.