Elliot James Devinney, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DS041295 Issued in PA

Practice address

USA Dental Activity, Attn: MCDS NA B
BLDG 6837 Normandy Drive
Fort Bragg, NC 28310-7302

Phone

(910) 643-2196

Fax

(910) 396-7017

NPI assigned

Aug 17, 2017

Last updated

Aug 17, 2017By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1502928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502928000000",
    "number": "1609392034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 CASSELL DR APT 204",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283111606",
            "telephone_number": "724-316-9563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "USA DENTAL ACTIVITY, ATTN: MCDS NA B",
            "address_2": "BLDG 6837 NORMANDY DRIVE",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283107302",
            "telephone_number": "910-643-2196",
            "fax_number": "910-396-7017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVINNEY",
        "first_name": "ELLIOT",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-17",
        "last_updated": "2017-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS041295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "DS041295",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Lauren Dempsey, PA
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• Gerald Douglas Depold
• Nicholas Derfler
• Raffaella Derosa, M.D.
• Zachary Devirgilio, PT, DPT, CSCS
• Alexia Ann Dewane, DMD
• Dfas Attn: Dfasin/ Adamb
• Sandeep Dhanjal, M.D.
• Jeannie Schumpert Dias, D.O.

• Dentist in Fort Bragg, NC
• Providers in Fort Bragg, NC by specialty
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2017; 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.