Active NPI
Rosemary Evans, DDS
- Dentist
- San Jose, CA
National Provider Identifier
1003021494
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DD033083
- Practice address
- 2680 S White Road
Suite 100
San Jose, CA 95148 - Phone
- (408) 531-9881
- Fax
- (408) 531-9580
- NPI assigned
- May 11, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DD033083 | CA | Primary |
Addresses
Primary practice location
2680 S White Road
Suite 100
San Jose, CA 95148
Mailing address
46096 Valena Street
Dos Palos, CA 93620
Phone (408) 391-9501
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 033083CA | Other | DELTA DENTAL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DD033083 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1003021494",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "46096 VALENA STREET",
"city": "DOS PALOS",
"state": "CA",
"postal_code": "93620",
"telephone_number": "408-391-9501",
"fax_number": "209-392-1378"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2680 S WHITE ROAD",
"address_2": "SUITE 100",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "95148",
"telephone_number": "408-531-9881",
"fax_number": "408-531-9580"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "ROSEMARY",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "DD033083",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DELTA DENTAL",
"identifier": "033083CA",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- 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.