Provider Demographics
NPI:1346681483
Name:ORVIN, DEVIN JAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:DEVIN
Middle Name:JAY
Last Name:ORVIN
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 1:24 S 500 W
Mailing Address - Street 2:
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-1916
Mailing Address - Country:US
Mailing Address - Phone:801-296-1606
Mailing Address - Fax:
Practice Address - Street 1:24 S 500 W
Practice Address - Street 2:
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010-1916
Practice Address - Country:US
Practice Address - Phone:801-296-1606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-16
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29067122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist