NPIMap

Organization Active NPI

Dr Jaime V. Evangelista Jr., DMD

  • Dentist
  • Hayward, CA
National Provider Identifier
1215396809
Registry record updated Feb 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
37103 Issued in CA
Legal business name
DR JAIME V. EVANGELISTA JR., DMD
Practice address
24901 Santa Clara St # B2
Hayward, CA 94544-2147
Phone
(510) 887-6835
Fax
(510) 887-2872
NPI assigned
Feb 11, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2016

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

Authorized official

Name
Dr. Jaime V Evangelista Jr., DMD
Title
Dentist
Phone
(510) 887-6835

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 37103 CA Primary

Addresses

Primary practice location

24901 Santa Clara St # B2
Hayward, CA 94544-2147

Mailing address

24901 Santa Clara St # B2
Hayward, CA 94544-2147
Phone (510) 887-6835

Other names 1

  • gateway plaza dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dr Jaime V Evangelista Jr DMD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1455148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455148800000",
    "number": "1215396809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24901 SANTA CLARA ST # B2",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945442147",
            "telephone_number": "510-887-6835",
            "fax_number": "510-887-2872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24901 SANTA CLARA ST # B2",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945442147",
            "telephone_number": "510-887-6835",
            "fax_number": "510-887-2872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR JAIME V. EVANGELISTA JR., DMD",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-11",
        "last_updated": "2016-02-11",
        "status": "A",
        "authorized_official_last_name": "EVANGELISTA",
        "authorized_official_first_name": "JAIME",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "510-887-6835",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "37103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "gateway plaza dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hayward, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2016; 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.