Active NPI
Devin Charles Irene, DDS
- Dentist
- Mountain View, WY
National Provider Identifier
1831681915
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 1497
- 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, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 10830741-9922 | UT | MD | Dentist |
| 1497 | WY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prince Dental Group PLLC | Dentist | Past | Accepting new patients |
| Blacks Fork Dental, PC | Past | 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.
-
- Dental Clinic/Center
- Mt View, WY
- NPI 1508322603
-
- Dentist
- Midway, UT
- NPI 1285044206
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.