Devan Michael Munk, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

D5596 Issued in ID

Practice address

3003 W Main St Ste 130
Boise, ID 83702-2026

Phone

(208) 342-7610

NPI assigned

Mar 24, 2020

Last updated

Oct 14, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Whitewater Oral Surgery Group PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Boise, ID
  • NPI 1104248053
  NPD

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

{
    "created_epoch": "1585008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760400000000",
    "number": "1255968053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 W MAIN ST STE 130",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837022026",
            "telephone_number": "208-342-7610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3003 W MAIN ST STE 130",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837022026",
            "telephone_number": "208-342-7610"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11575 W State St",
            "address_purpose": "LOCATION",
            "city": "Star",
            "state": "ID",
            "postal_code": "836695221",
            "country_code": "US",
            "telephone_number": "208-286-7755",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3015 E Goldstone Dr Ste 140",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "ID",
            "postal_code": "836421224",
            "country_code": "US",
            "telephone_number": "208-342-7610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUNK",
        "first_name": "DEVAN",
        "middle_name": "MICHAEL",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-24",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "ID",
            "license": "D5596",
            "primary": true
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "ID",
            "license": "D5596",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Howell Mumford, D.M.D.
• Aziz George Munayirji, MD
• Laura Mundy, LPC, NCC
• Jordan Ari-Roger Munger
• Lisa A Munger, CRNA, MAE
• Stacia S Munn, MD
• Cedric Munoz, M.D.
• David Michael Munro, DDS
• Heidi R Munro, PA
• Ares Munson, CBRS/CM

• Oral and Maxillofacial Surgery (Dentist) in Boise, ID
• Providers in Boise, ID by specialty
• Oral and Maxillofacial Surgery (Dentist) in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2025; 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.