Individual provider Active NPI

Darwin Harold Evans, DMD

  • Dentist
  • North Las Vegas, NV
National Provider Identifier
1144529942
Registry record updated Mar 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6133 Issued in NV
Practice address
3896 North Martin Luther King Blvd
North Las Vegas, NV 89032
Phone
(702) 614-1792
Fax
(702) 933-0190
NPI assigned
Mar 18, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6133 NV Primary
Dentist 122300000X 7839001-9921 UT

Addresses

Primary practice location

3896 North Martin Luther King Blvd
North Las Vegas, NV 89032

Mailing address

3896 North Martin Luther King Blvd
North Las Vegas, NV 89032
Phone (702) 614-1792

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7839001-9921UTMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Lee MLK Dental Group, PC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1300406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300406400000",
    "number": "1144529942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3896 NORTH MARTIN LUTHER KING BLVD",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "89032",
            "telephone_number": "702-614-1792",
            "fax_number": "702-933-0190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3896 NORTH MARTIN LUTHER KING BLVD",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "89032",
            "telephone_number": "702-614-1792",
            "fax_number": "702-933-0190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "DARWIN",
        "middle_name": "HAROLD",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-18",
        "last_updated": "2011-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NV",
            "license": "6133",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "7839001-9921",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.