Individual provider Active NPI

Debbie Desravines, DMD

  • Student in an Organized Health Care Education/Training Program
  • Bronx, NY
National Provider Identifier
1255863114
Registry record updated Mar 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1775 Grand Concourse 6TH Floor
Bronx Lebanon Hospital Center, Dept. of Dentistry
Bronx, NY 10453
Phone
(718) 901-8110
NPI assigned
Mar 30, 2017
Last updated
Mar 30, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1775 Grand Concourse 6TH Floor
Bronx Lebanon Hospital Center, Dept. of Dentistry
Bronx, NY 10453

Mailing address

760 Pennsylvania Ave
Fort Lauderdale, FL 33312-2625
Phone (954) 707-8510

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1490832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490832000000",
    "number": "1255863114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 PENNSYLVANIA AVE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333122625",
            "telephone_number": "954-707-8510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 GRAND CONCOURSE 6TH FLOOR",
            "address_2": "BRONX LEBANON HOSPITAL CENTER, DEPT. OF DENTISTRY",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10453",
            "telephone_number": "718-901-8110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESRAVINES",
        "first_name": "DEBBIE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-30",
        "last_updated": "2017-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.