A Smile by Dr. Devese, LLC.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3019883 Issued in OH

Legal business name

A SMILE BY DR. DEVESE, LLC.

Practice address

105 Commerce Park Dr Ste B
Westerville, OH 43082-6060

Phone

(614) 890-0905

Fax

(614) 890-4005

NPI assigned

Mar 8, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Larry Devese, D.D.S.

Title

Owner

Phone

(614) 890-0905

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629109947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 COMMERCE PARK DR STE B",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430826060",
            "telephone_number": "614-890-0905",
            "fax_number": "614-890-4005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 COMMERCE PARK DR STE B",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430826060",
            "telephone_number": "614-890-0905",
            "fax_number": "614-890-4005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A SMILE BY DR. DEVESE, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DEVESE",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "614-890-0905",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "3019883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.