Individual provider Active NPI

Devin Eugene Widick, DDS

  • Dentist
  • Saint Louis, MO
National Provider Identifier
1376472258
Registry record updated May 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8224 Issued in OK
Practice address
3320 Rutger St
Saint Louis, MO 63104-1122
Phone
(314) 977-8363
NPI assigned
May 16, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 8224 OK Primary

Addresses

Primary practice location

3320 Rutger St
Saint Louis, MO 63104-1122

Mailing address

1518 Mockingbird LN
Weatherford, OK 73096-2738
Phone (580) 334-9423

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": "1778889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778889600000",
    "number": "1376472258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1518 MOCKINGBIRD LN",
            "city": "WEATHERFORD",
            "state": "OK",
            "postal_code": "730962738",
            "telephone_number": "580-334-9423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3320 RUTGER ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041122",
            "telephone_number": "314-977-8363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDICK",
        "first_name": "DEVIN",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-05-16",
        "last_updated": "2026-05-16",
        "certification_date": "2026-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "8224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2026; 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.