Provider Demographics
NPI:1346423555
Name:DEVEAUX, CANDACE (DDS)
Entity Type:Individual
Prefix:DR
First Name:CANDACE
Middle Name:
Last Name:DEVEAUX
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 14TH ST. NE
Mailing Address - Street 2:APT. 437
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309
Mailing Address - Country:US
Mailing Address - Phone:404-618-4300
Mailing Address - Fax:
Practice Address - Street 1:222 14TH ST NE
Practice Address - Street 2:#437
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-7678
Practice Address - Country:US
Practice Address - Phone:404-618-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-11
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0151281223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics