Jonathan David Evans, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

19482 Issued in TX

Practice address

301 Fisher St
Biloxi, MS 39534

Phone

(228) 376-0511

NPI assigned

Oct 4, 2005

Last updated

Aug 3, 2018By the provider in NPPES

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

Other names 1

• Dr. Jonathan David Evans Professional name

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533254400000",
    "number": "1033106000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "MIL",
            "address_1": "52D MEDICAL GROUP",
            "address_2": "UNIT 3865",
            "city": "APO",
            "state": "AE",
            "postal_code": "091263865",
            "telephone_number": "496565913590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 FISHER ST",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "39534",
            "telephone_number": "228-376-0511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "JONATHAN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2018-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "19482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JONATHAN",
            "last_name": "EVANS",
            "middle_name": "DAVID",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Regina L Escher, C.F.N.P.
• Earl Edward Eskridge IV, PHARMD, RPH
• Eternity Wellness 22, LLC
• James Jules Eustice, DMD
• Annamae Evans, LMT
• Kimberly S Evans, CST/CSFA
• Theron Evans
• Exceed of Ms, LLC (Exceed Physical Therapy of Biloxi)
• Eye Associates of the South
• Eye Associates of the South PLLC

• Pediatric Dentistry in Biloxi, MS
• Providers in Biloxi, MS by specialty
• Pediatric Dentistry in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.