Evans Dental PA

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

EVANS DENTAL PA

Practice address

1308 Bennett Ave
Burley, ID 83318-2665

Phone

(208) 647-4441

NPI assigned

Nov 26, 2018

Last updated

Nov 26, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mark Evans, DMDNPI 1750731212

Title

Dentist/Owner

Phone

(208) 647-4441

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark Evans, DMD

  • Dentist
  • Nampa, ID
  • NPI 1750731212
  NPD Authorized official

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

{
    "created_epoch": "1543190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543190400000",
    "number": "1205306941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1308 BENNETT AVE",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833182665",
            "telephone_number": "208-647-4441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1308 BENNETT AVE",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833182665",
            "telephone_number": "208-647-4441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVANS DENTAL PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-26",
        "last_updated": "2018-11-26",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "208-647-4441",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33733",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Eide, MD
• Elite Physical Therapy and Health, LLC
• Misty R Enger
• Lynne Eppers
• Katelin Tingey Erekson, CF-SLP
• Evans Family Chiropractic, LLC.
• Erik R. Evans, CHIROPRACTOR
• Evening Medical Clinic
• F. B. Fitts Jr., M.D. PC
• Family Health Services Corporation

• Dental Clinic/Center in Burley, ID
• Providers in Burley, ID by specialty
• Dental Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2018; 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.