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General NPI Number Information
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NPI Number | 1396663043
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Entity Type | Organization
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Legal Business Name | DEVGON ORTHODONTICS, PPLC
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Dates
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Enumeration Date | 07/09/2026
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Last Update Date | 07/09/2026
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Provider Practice Location Address
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Address Line | 2875 W WHITESTONE BLVD STE 150
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City | CEDAR PARK
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State | TX
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Zip | 78613-8005
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Country | US
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Telephone | 904-868-3495
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Fax |
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Provider Business Mailing Address
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Address Line | 1201 MORNING MOON CIR
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City | AUSTIN
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State | TX
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Zip | 78732-6145
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Country | US
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Telephone | 904-868-3495
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Fax |
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | DR. DENISE DEVGON
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Credential | DDS, MS
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Telephone | 904-868-3495
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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