Brian David Evans, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

61230 Issued in CA

Practice address

Uss Carl Vinson Cvn70
Unit 1000111 Box 1770
Fpo, AP 96629

Phone

(619) 545-4814

NPI assigned

Nov 22, 2010

Last updated

Mar 7, 2023By 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 identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• San Diego Maxillofacial Surgery, Evans-Hammer Dental Corporation

  • Oral and Maxillofacial Surgery (Dentist)
  • Escondido, CA
  • NPI 1093523656
  NPD Authorized official
• Arshiya Sharafi, DDS, PC

  • Oral and Maxillofacial Surgery (Dentist)
  • San Diego, CA
  • NPI 1548637002
  NPD (past)
• Marilyn Kaufhold, M.D., a Medical Corporation

  • Children's Hospital
  • San Diego, CA
  • NPI 1336359389
  NPD (past)

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

{
    "created_epoch": "1290384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1114229317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4796 PANORAMA DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921161239",
            "telephone_number": "208-757-0787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "MIL",
            "address_1": "USS CARL VINSON CVN70",
            "address_2": "UNIT 1000111 BOX 1770",
            "city": "FPO",
            "state": "AP",
            "postal_code": "96629",
            "telephone_number": "619-545-4814"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4125 Sorrento Valley Blvd Ste D",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921211423",
            "country_code": "US",
            "telephone_number": "858-997-2701",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "H100 Santa Maargarita Road",
            "address_purpose": "LOCATION",
            "city": "Marine Coprs Base Camp Pendleton",
            "state": "CA",
            "postal_code": "92055",
            "country_code": "US",
            "telephone_number": "760-725-1200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVANS",
        "first_name": "BRIAN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-11-22",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "61230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GENERAL ANESTHESIA PERMIT",
            "identifier": "GA1863",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "61230",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.