Evan L Perry, D D S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

142103 Issued in UT

Practice address

320 River Park Dr
Suite 225
Provo, UT 84604-6060

Phone

(801) 225-7111

Fax

(801) 764-9777

NPI assigned

May 1, 2012

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 identifiers 1

Medicare fee-for-service enrollment

Enrolled in UT

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

Practice roles

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.

• Evan L Perry DDS PC

  • General Practice Dentistry
  • Provo, UT
  • NPI 1134244734
  NPD (past) Authorized official

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

{
    "created_epoch": "1335830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335830400000",
    "number": "1104184837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 RIVER PARK DR",
            "address_2": "SUITE 225",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846046060",
            "telephone_number": "801-225-7111",
            "fax_number": "801-764-9777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 RIVER PARK DR",
            "address_2": "SUITE 225",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846046060",
            "telephone_number": "801-225-7111",
            "fax_number": "801-764-9777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "EVAN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D D S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-01",
        "last_updated": "2012-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "142103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1134244734",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sadie Perrine
• Amberly Perrins, ATC, LAT
• Ryan G Perron
• Anne Perry, M.D.
• David Earl Perry, DO
• Kimberly Dawn Perry, SSW
• Megan Perry
• Michael Perry
• Tanner Gardner Perry, DMD
• Stephen Peters, PSYD

• General Practice Dentistry in Provo, UT
• Providers in Provo, UT by specialty
• General Practice Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2012; 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.