Provider Demographics
NPI:1295857779
Name:DEVINS, STEVEN RAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:RAY
Last Name:DEVINS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 N ORLANDO AVE
Mailing Address - Street 2:#101
Mailing Address - City:COCOA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32931-3171
Mailing Address - Country:US
Mailing Address - Phone:321-784-4321
Mailing Address - Fax:321-784-4322
Practice Address - Street 1:503 N ORLANDO AVE
Practice Address - Street 2:#101
Practice Address - City:COCOA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32931-3171
Practice Address - Country:US
Practice Address - Phone:321-784-4321
Practice Address - Fax:321-784-4322
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL51041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice