Individual provider Active NPI

Barbara Jean Devine, D.M.D. M.A.G.D.

  • General Practice Dentistry
  • Greenwich, CT
National Provider Identifier
1295931798
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
CT 5174 Issued in CT
Practice address
4 Dearfield Dr
Suite 202
Greenwich, CT 06831-5351
Phone
(203) 629-9009
Fax
(203) 629-0039
NPI assigned
Jun 22, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X CT 5174 CT Primary

Addresses

Primary practice location

4 Dearfield Dr
Suite 202
Greenwich, CT 06831-5351

Mailing address

4 Dearfield Dr
Suite 202
Greenwich, CT 06831-5351
Phone (203) 629-9009

Other identifiers 1

IdentifierTypeStateIssuer
5174OtherCTSTATE LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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

Enrollment IDStateProvider typePAC IDDetails
I20160412000218 CT Order and Referring Only - DentistPractitioner - Dentist 6002114899

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CT 5174CTMDGeneral Practice Dentistry
5174CTMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1182470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295931798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 DEARFIELD DR",
            "address_2": "SUITE 202",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068315351",
            "telephone_number": "203-629-9009",
            "fax_number": "203-629-0039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 DEARFIELD DR",
            "address_2": "SUITE 202",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068315351",
            "telephone_number": "203-629-9009",
            "fax_number": "203-629-0039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVINE",
        "first_name": "BARBARA",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "D.M.D. M.A.G.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "CT 5174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "5174",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwich, CT

Sources for this page

Verify at the official NPI Registry.