Michael R Evan, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

30019263 Issued in OH

Practice address

425 N Main St
Munroe Falls, OH 44262

Phone

(330) 688-4942

Fax

(330) 688-9064

NPI assigned

Jan 12, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Munroe Falls Family Dentistry Co

  • Dentist
  • Munroe Falls, OH
  • NPI 1740330489
  NPD (past) Authorized official

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205986940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 216",
            "address_2": "425 N MAIN ST",
            "city": "MUNROE FALLS",
            "state": "OH",
            "postal_code": "44262",
            "telephone_number": "330-688-4942",
            "fax_number": "330-688-9064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 N MAIN ST",
            "city": "MUNROE FALLS",
            "state": "OH",
            "postal_code": "44262",
            "telephone_number": "330-688-4942",
            "fax_number": "330-688-9064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVAN",
        "first_name": "MICHAEL",
        "middle_name": "R",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30019263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsay Conner
• Leslie Anne Darden
• Scott Lawrence Day, RN
• Julia Dulc
• Jacklyn Lee Voytko Dunn
• Maria Evans
• Fairhaven Foundation, Inc.
• Family Care Plus Clinic LLC
• Ellen Noreen Friedman, MACCC SLP
• Ryan Thomas Goughnour, A.T.C.

• Dentist in Munroe Falls, OH
• Providers in Munroe Falls, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.