Evan James Agnetta, DDS, MS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

0000011286 Issued in TN

Practice address

6311 Kingston Pike Ste 26W
Knoxville, TN 37919-4900

Phone

(208) 761-1210

NPI assigned

Sep 18, 2020

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Agnetta Orthodontics PLLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Knoxville, TN
  • NPI 1740888023

  Orthodontics and Dentofacial Orthopedics

  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1600387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600387200000",
    "number": "1013523703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 IVES ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136014216",
            "telephone_number": "208-761-1210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6311 KINGSTON PIKE STE 26W",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379194900",
            "telephone_number": "208-761-1210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGNETTA",
        "first_name": "EVAN",
        "middle_name": "JAMES",
        "credential": "DDS, MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-18",
        "last_updated": "2020-09-18",
        "certification_date": "2020-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TN",
            "license": "0000011286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Agilitas USA, Inc
• Agilitas USA, Inc.
• Agilitas USA, Inc.
• Rebecca Johnson Agner, DO
• Agnetta Orthodontics PLLC
• Jasmine Maria Aguirre, MA
• Lindsay Agulto
• Craig Ahern
• Michelle Erin Ahern, BA
• Alyssia Jayne Ahhaitty

• All providers in Knoxville, TN
• Orthodontics and Dentofacial Orthopedics Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.