De Andre Evans
Individual provider Active NPI General Practice Dentistry · Newport, KY
NPI 1063372365 · NPPES record last updated Nov 18, 2025
Key facts
- NPI
- 1063372365
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- D-00097 (KY)
- Practice address
- 215 E 11TH St
Newport, KY 41071-2203 - Phone
- (859) 655-6100
- Fax
- (859) 655-6186
- NPI assigned
- Nov 18, 2025
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Dentist
- Education
- Ohio State University College of Dentistry, 2025
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
215 E 11TH St
Newport, KY 41071-2203
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260106000305 | KY | Practitioner - Dentist | 9830685247 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D-00097 | KY | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healthpoint Family Care, Inc. | Current |
Accepting new patients | |
| Healthpoint Family Care Inc | Current |
Accepting new patients |
Locations
1401 Madison Ave
Covington, KY 41011
Phone (606) 655-8034
215 E 11th St
Newport, KY 41071
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D-00097 | KY | Yes |
Addresses
Primary practice location
215 E 11TH St
Newport, KY 41071-2203
Mailing address
215 E 11TH St
Newport, KY 41071-2203
Phone (859) 655-6100
Other providers in Newport, KY
- Tamara England
- Audrey Ertel
- Allyson Karen Essell
- Ethos Holding Corp
- Amanda M Evans
- Grace Ellen Evans
- Express Mobile Transportation
- Faith Community Clinic Incorporated
- Family Chiropractic Center, Inc.
- Zachary Fannin
All providers in Newport, KY · General Practice Dentistry in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 18, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.