Evan Georgieff, DDS, Inc.

Primary specialty

DentistTaxonomy code 122300000X

License

B38528 Issued in CA

Legal business name

EVAN GEORGIEFF, DDS, INC.

Practice address

620 W Edinger Ave
Santa Ana, CA 92707

Phone

(714) 668-1602

Fax

(714) 540-4683

NPI assigned

Nov 17, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Evan Paul Georgieff, DDS

Title

Owner/Dentist

Phone

(949) 412-7900

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445299200000",
    "number": "1194899864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 W EDINGER AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "92707",
            "telephone_number": "714-668-1602",
            "fax_number": "714-540-4683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 W EDINGER AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "92707",
            "telephone_number": "714-668-1602",
            "fax_number": "714-540-4683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVAN GEORGIEFF, DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2015-10-20",
        "status": "A",
        "authorized_official_last_name": "GEORGIEFF",
        "authorized_official_first_name": "EVAN",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "949-412-7900",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "B38528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2015; 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.