Devan William Moody, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2901022562 Issued in MI

Practice address

308 Northgate Dr
Midland, MI 48640-7348

Phone

(989) 631-7880

NPI assigned

May 23, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Great Lakes Bay Health Centers

  • Obstetrics & Gynecology Physician
  • Saginaw, MI
  • NPI 1871684761
  Medicare reassignment
• McLaren Dental Associates, P.C.

  • General Practice Dentistry
  • Midland, MI
  • NPI 1205945573

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1527033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1639660806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 NORTHGATE DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486407348",
            "telephone_number": "989-631-7880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 NORTHGATE DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486407348",
            "telephone_number": "989-631-7880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "308 Northgate Dr",
            "address_purpose": "LOCATION",
            "city": "Midland",
            "state": "MI",
            "postal_code": "486407348",
            "country_code": "US",
            "telephone_number": "989-631-7880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOODY",
        "first_name": "DEVAN",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-23",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901022562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heidi Elizabeth Monaghan, DPM
• Alyssa Montague, MA, LPC
• Emmy Montgomery
• Michelle Laforet Monticello, MD
• Richard Montpetit, MD
• Kathleen Moon
• Rachel Elizabeth Moon
• Ashley Marie Moore, OTRL
• Mikayla Moore, LMT
• Shirley Ann Moore, M.S., R.AC.

• Dentist in Midland, MI
• Providers in Midland, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.