San Diego Maxillofacial Surgery, Evans-Hammer Dental Corporation

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

SAN DIEGO MAXILLOFACIAL SURGERY, EVANS-HAMMER DENTAL CORPORATION

Practice address

2185 Citracado Pkwy
Escondido, CA 92029-4159

Phone

(805) 455-6057

NPI assigned

Dec 27, 2024

Organization subpart

No

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

Authorized official

Name

Brian EvansNPI 1114229317

Title

Owner/Authorized Official

Phone

(858) 335-8892

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brian David Evans, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • NPI 1114229317
  NPD Authorized official

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

{
    "created_epoch": "1735257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735257600000",
    "number": "1093523656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27028",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921981028",
            "telephone_number": "805-455-6057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2185 CITRACADO PKWY",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920294159",
            "telephone_number": "805-455-6057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN DIEGO MAXILLOFACIAL SURGERY, EVANS-HAMMER DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-27",
        "last_updated": "2024-12-27",
        "certification_date": "2024-12-27",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "OWNER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "858-335-8892"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Escondido, CA
• Providers in Escondido, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2024; 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.