Individual provider Active NPI

Devin Charles Irene, DDS

  • Dentist
  • Mountain View, WY
National Provider Identifier
1831681915
Registry record updated Jan 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1497 Issued in WY
Practice address
650 Parkway Dr
Mountain View, WY 82939
Phone
(307) 782-3630
Fax
(307) 782-3632
NPI assigned
Jun 4, 2018
Last updated
Jan 29, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 10830741-9922 UT
Dentist 122300000X 1497 WY Primary

Addresses

Primary practice location

650 Parkway Dr
Mountain View, WY 82939

Mailing address

50 Park Rd
Evanston, WY 82930-2613
Phone (307) 789-5608

Other practice location 1

210 E Main St Ste 201
Midway, UT 84049-6817
Phone (435) 654-2822

Other practice location 2

50 Park Rd
Evanston, WY 82930-2613
Phone (307) 789-5608

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
10830741-9922UTMDDentist
1497WYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Prince Dental Group PLLC Dentist Past Accepting new patients
Blacks Fork Dental, PC PastSince Jan 31, 2021 Accepting new patients
Bear River Dental Dentist Past Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1528070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611878400000",
    "number": "1831681915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 PARK RD",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "829302613",
            "telephone_number": "307-789-5608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 PARKWAY DR",
            "city": "MOUNTAIN VIEW",
            "state": "WY",
            "postal_code": "82939",
            "telephone_number": "307-782-3630",
            "fax_number": "307-782-3632"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "210 E Main St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Midway",
            "state": "UT",
            "postal_code": "840496817",
            "country_code": "US",
            "telephone_number": "435-654-2822",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "50 Park Rd",
            "address_purpose": "LOCATION",
            "city": "Evanston",
            "state": "WY",
            "postal_code": "829302613",
            "country_code": "US",
            "telephone_number": "307-789-5608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IRENE",
        "first_name": "DEVIN",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-04",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "10830741-9922",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WY",
            "license": "1497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain View, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2021; 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.