Active NPI
Debra Vivian Irvin, DDS
- General Practice Dentistry
- Phila, PA
National Provider Identifier
1497735666
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DS023289L
- Practice address
- 5201 N Broad St
Phila, PA 19141-1627 - Phone
- (215) 329-5512
- Fax
- (215) 329-0401
- NPI assigned
- Jan 22, 2006
- 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 | DS023289L | PA | Primary |
Addresses
Primary practice location
5201 N Broad St
Phila, PA 19141-1627
Mailing address
5201 N Broad St
Phila, PA 19141-1627
Phone (215) 329-5512
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137888000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1497735666",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5201 N BROAD ST",
"city": "PHILA",
"state": "PA",
"postal_code": "191411627",
"telephone_number": "215-329-5512",
"fax_number": "215-329-0401"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5201 N BROAD ST",
"city": "PHILA",
"state": "PA",
"postal_code": "191411627",
"telephone_number": "215-329-5512",
"fax_number": "215-329-0401"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IRVIN",
"first_name": "DEBRA",
"middle_name": "VIVIAN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-01-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "PA",
"license": "DS023289L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phila, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.