Active NPI
Devin Lee Dezern, D.D.S.
- General Practice Dentistry
- Dallas, TX
National Provider Identifier
1316108236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 23981
- Practice address
- 7700 Greenway Blvd
#H103
Dallas, TX 75209-7323 - Phone
- (214) 930-2312
- NPI assigned
- Jun 23, 2008
- Last updated
- Apr 9, 2013
- 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 | 23981 | TX | Primary |
Addresses
Primary practice location
7700 Greenway Blvd
#H103
Dallas, TX 75209-7323
Mailing address
7700 Greenway Blvd
#H103
Dallas, TX 75209-7323
Phone (214) 930-2312
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23981 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214179200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1365465600000",
"number": "1316108236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7700 GREENWAY BLVD",
"address_2": "#H103",
"city": "DALLAS",
"state": "TX",
"postal_code": "752097323",
"telephone_number": "214-930-2312"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7700 GREENWAY BLVD",
"address_2": "#H103",
"city": "DALLAS",
"state": "TX",
"postal_code": "752097323",
"telephone_number": "214-930-2312"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEZERN",
"first_name": "DEVIN",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-06-23",
"last_updated": "2013-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "23981",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.