Jeffrey R Evanko DMD LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

JEFFREY R EVANKO DMD LLC

Doing business as

Evanko Dental Group of Medina

Practice address

3637 Medina Rd Ste 200
Medina, OH 44256-8154

Phone

(330) 725-6182

NPI assigned

Nov 18, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Jeffrey R Evanko, DMD

Title

Owner/ Dentist

Phone

(330) 725-6182

Specialties & licenses 1

Addresses

Other names 1

• Evanko Dental Group of Medina Doing business as

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

{
    "created_epoch": "1605657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606176000000",
    "number": "1164025623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3637 MEDINA RD STE 200",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442568154",
            "telephone_number": "330-725-6182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3637 MEDINA RD STE 200",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442568154",
            "telephone_number": "330-725-6182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY R EVANKO DMD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-18",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A",
        "authorized_official_last_name": "EVANKO",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER/ DENTIST",
        "authorized_official_telephone_number": "330-725-6182",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evanko Dental Group of Medina",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Evanko Dental Group of Medina",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bijay K. Jayaswal, M.D.
• Angela Jeanette Jayes, RN, CNP
• Natalie P Jedacek, M.D.
• Jeffers and Sons LLC
• Shaquille Jefferson
• Tiffany Jiamachello, NP
• Francine E. Johns, P.A.-C
• Angela Johnson, LMT
• Hollie Johnson
• Jessica Lynne Johnson, CNP

• General Practice Dentistry in Medina, OH
• Providers in Medina, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2020; 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.