Active NPI
Evert Michael Cowan
- Dentist
- Moreno Valley, CA
National Provider Identifier
1215424379
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 103315
- Practice address
- 12420 Day St Ste B4
Moreno Valley, CA 92553-7536 - Phone
- (951) 656-6538
- NPI assigned
- Apr 15, 2018
- Last updated
- Mar 3, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 103315 | CA | Primary |
Addresses
Primary practice location
12420 Day St Ste B4
Moreno Valley, CA 92553-7536
Mailing address
27460 Finale CT
Menifee, CA 92584-7232
Phone (301) 328-6242
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 103315 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1523750400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583193600000",
"number": "1215424379",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27460 FINALE CT",
"city": "MENIFEE",
"state": "CA",
"postal_code": "925847232",
"telephone_number": "301-328-6242"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12420 DAY ST STE B4",
"city": "MORENO VALLEY",
"state": "CA",
"postal_code": "925537536",
"telephone_number": "951-656-6538"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COWAN",
"first_name": "EVERT",
"middle_name": "MICHAEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-04-15",
"last_updated": "2020-03-03",
"certification_date": "2020-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "103315",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moreno Valley, CA
- Telana Mone Courseault
- Coury & Buehler Physical Therapy - Moreno Valley, Inc. (Coury & Buehler Physical Therapy)
- Coury & Buehler Physical Therapy, Inc. (Coury & Buehler Physical Therapy - Moreno Valley)
- Alexandra Covarrubias
- Rachel Barbara Covington
- Kathryn Dianne Cowan, RPH
- Georgina Muriel Cowie, MFT-I
- Cox Dental Coprporation (Gentle Dental Moreno Valley)
- Robert Christopher Craig
- Michelle Crain
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.