NPIMap

Organization Active NPI

William R. Evans, DDS, Apc

  • General Practice Dentistry
  • Eagle River, AK
National Provider Identifier
1083760896
Registry record updated Feb 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
555 Issued in AK
Legal business name
WILLIAM R. EVANS, DDS, APC
Practice address
16635 Centerfield Dr
Suite 205
Eagle River, AK 99577-7719
Phone
(907) 694-5150
Fax
(907) 694-1317
NPI assigned
Jan 25, 2007
Last updated
Feb 17, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2010

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

Authorized official

Name
Dr. William R Evans, DDSNPI 1891014064
Title
President
Phone
(907) 694-5150

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 555 AK Primary

Addresses

Primary practice location

16635 Centerfield Dr
Suite 205
Eagle River, AK 99577-7719

Mailing address

16635 Centerfield Dr
Suite 205
Eagle River, AK 99577-7719
Phone (907) 694-5150

Other identifiers 1

IdentifierTypeStateIssuer
DD0555MedicaidAK

National Provider Directory

National Provider Directory

Locations

16635 Centerfield Dr
Ste 205
Eagle River, AK 99577
Phone (907) 694-5150

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266364800000",
    "number": "1083760896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16635 CENTERFIELD DR",
            "address_2": "SUITE 205",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995777719",
            "telephone_number": "907-694-5150",
            "fax_number": "907-694-1317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16635 CENTERFIELD DR",
            "address_2": "SUITE 205",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995777719",
            "telephone_number": "907-694-5150",
            "fax_number": "907-694-1317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM R. EVANS, DDS, APC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2010-02-17",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "907-694-5150",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AK",
            "license": "555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DD0555",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle River, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2010; 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.