Developmental Dentistry, PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

DEVELOPMENTAL DENTISTRY, PLLC

Practice address

79 W Alexandrine St
3Rd. Floor
Detroit, MI 48201-2015

Phone

(313) 576-2538

Fax

(313) 576-2534

NPI assigned

Sep 8, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Sue Fagan

Title

Business Coordinator

Phone

(313) 576-2538

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1220832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220832000000",
    "number": "1679721294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 W ALEXANDRINE ST",
            "address_2": "3RD. FLOOR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012015",
            "telephone_number": "313-576-2538",
            "fax_number": "313-576-2534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 W ALEXANDRINE ST",
            "address_2": "3RD. FLOOR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012015",
            "telephone_number": "313-576-2538",
            "fax_number": "313-576-2534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVELOPMENTAL DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-08",
        "last_updated": "2008-09-08",
        "status": "A",
        "authorized_official_last_name": "FAGAN",
        "authorized_official_first_name": "SUE",
        "authorized_official_title_or_position": "BUSINESS COORDINATOR",
        "authorized_official_telephone_number": "313-576-2538",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dental Hygienist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anupama Devara, MD
• Development Centers
• Development Centers, Inc.
• Development Centers, Inc.
• Development Centers, Inc.
• Nichole Devenney
• Devine Physical Therapy and Rehabilitation
• Devine Services
• Samantha Devlin, DDS
• Robert Devore

• Pediatric Dentistry in Detroit, MI
• Providers in Detroit, MI by specialty
• Pediatric Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2008; 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.