NPIMap

Organization Active NPI

J. Evans, DMD, P.S.

  • Pediatric Dentistry
  • Liberty Lake, WA
National Provider Identifier
1144427964
Registry record updated Mar 31, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
10191 Issued in WA
Legal business name
J. EVANS, DMD, P.S.
Practice address
1327 N Stanford Lane
Suite B
Liberty Lake, WA 99019
Phone
(509) 891-7070
Fax
(509) 891-4741
NPI assigned
Jun 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2009

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

Authorized official

Name
Dr. Jared D Evans, DMDNPI 1306927892
Title
Owner-Dentist
Phone
(509) 891-7070

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
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 10191 WA Primary

Addresses

Primary practice location

1327 N Stanford Lane
Suite B
Liberty Lake, WA 99019

Mailing address

1327 N Stanford Lane
Suite B
Liberty Lake, WA 99019
Phone (509) 891-7070

Other names 1

  • KiDDS Dental Doing business as

National Provider Directory

National Provider Directory

Locations

1327 N Stanford Ln
#B
Liberty Lake, WA 99019
Phone (509) 389-9333

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238457600000",
    "number": "1144427964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1327 N STANFORD LANE",
            "address_2": "SUITE B",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "99019",
            "telephone_number": "509-891-7070",
            "fax_number": "509-891-4741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1327 N STANFORD LANE",
            "address_2": "SUITE B",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "99019",
            "telephone_number": "509-891-7070",
            "fax_number": "509-891-4741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J. EVANS, DMD, P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-27",
        "last_updated": "2009-03-31",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "JARED",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER-DENTIST",
        "authorized_official_telephone_number": "509-891-7070",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WA",
            "license": "10191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KiDDS Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Liberty Lake, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2009; 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.