Derek Devries, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901021526 Issued in MI

Practice address

6650 Crossings Dr SE
Kentwood, MI 49508-7852

Phone

(616) 554-2100

NPI assigned

Jun 14, 2015

Sex

Male

Sole proprietor

No

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

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.

• Derek Devries DDS PLLC

  • General Practice Dentistry
  • Grand Rapids, MI
  • NPI 1952057762
  NPD Authorized official
• Pinerock,P.C.

  • General Practice Dentistry
  • Kentwood, MI
  • NPI 1962467662
  NPD (past)

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

{
    "created_epoch": "1434240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434240000000",
    "number": "1922489194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6650 CROSSINGS DR SE",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495087852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6650 CROSSINGS DR SE",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495087852",
            "telephone_number": "616-554-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVRIES",
        "first_name": "DEREK",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-14",
        "last_updated": "2015-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901021526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexis Monet Delk
• Amanda Demaray
• Ella Dendel
• Madison J Denison, BEHAVIOR TECHNICIAN
• Rhonda Jo Densborn, MA. L.L.P.
• Laura E Devries, PT, DPT
• Jordyn Diaz
• Leonora Diaz, MD
• Dignified Care LLC
• Kristie L Dilaura, LMSW

• General Practice Dentistry in Kentwood, MI
• Providers in Kentwood, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2015; 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.