James Allen Devengencie, D.D.S., M.S.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

30-01-9902 Issued in OH

Practice address

25111 Country Club Blvd
Ste. 201
North Olmsted, OH 44070-5345

Phone

(440) 686-3636

NPI assigned

May 21, 2007

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

Practice roles

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.

• Endodontics Limited Inc

  • Endodontics
  • North Olmsted, OH
  • NPI 1124121728
  NPD (past) Authorized official

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982813481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25111 COUNTRY CLUB BLVD",
            "address_2": "STE. 201",
            "city": "NORTH OLMSTED",
            "state": "OH",
            "postal_code": "440705345",
            "telephone_number": "440-686-3636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25111 COUNTRY CLUB BLVD",
            "address_2": "STE. 201",
            "city": "NORTH OLMSTED",
            "state": "OH",
            "postal_code": "440705345",
            "telephone_number": "440-686-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVENGENCIE",
        "first_name": "JAMES",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "OH",
            "license": "30-01-9902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dental Professionals Cleveland-Nouneh, Inc.
• Terence Robert Dentkos, DDS, MS
• Dentlife Dental Care
• Megan Burdick Desimone, DDS
• Jesse Desoto, PHARM.D, RPH
• Anthony Dibiasio, PH.D.
• Lauren Dietrich
• Christy C. Direnzo, D.D.S.
• Discount Drug Mart Inc
• Holly Ann Dobias

• Endodontics in North Olmsted, OH
• Providers in North Olmsted, OH by specialty
• Endodontics in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.