Burke Adam Devlin

Primary specialty

DentistTaxonomy code 122300000X

License

11312 Issued in TN

Practice address

590 Fire Station Rd Ste C
Clarksville, TN 37043-4076

Phone

(270) 798-8751

Fax

(270) 956-0266

NPI assigned

Jun 17, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Sango Hills Dental PLLC

  • Dental Clinic/Center
  • Clarksville, TN
  • NPI 1174393896
  NPD Authorized official

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

{
    "created_epoch": "1560729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1780244293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "590 FIRE STATION RD STE C",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370434076",
            "telephone_number": "931-820-2693",
            "fax_number": "270-956-0266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 FIRE STATION RD STE C",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370434076",
            "telephone_number": "270-798-8751",
            "fax_number": "270-956-0266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVLIN",
        "first_name": "BURKE",
        "middle_name": "ADAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-17",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "11312",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "6574972-9922",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Herat Vidyut Desai, PT
• Ashton B Deshotel
• Kaelyn Desmarais
• Lyn Marie Deters, OTR
• Rachel N Dever, B.S. SLPA
• William Henry Devries, MD
• Michaela Dew
• Ernest James Dewald, DDS
• Andrea J Dewey, BCBA
• Ashley Elizabeth Dial

• Dentist in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Dentist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; 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.