Evergreen Dental Corporation

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

EVERGREEN DENTAL CORPORATION

Practice address

10315 19TH Ave SE
Ste 102
Everett, WA 98208-4259

Phone

(425) 385-3170

Fax

(425) 385-3907

NPI assigned

Jun 4, 2006

Last updated

Aug 22, 2020By 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. T. Kevin Dang, DDSNPI 1831127687

Title

President

Phone

(425) 385-3170

Specialties & licenses 1

Addresses

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.

• T. Kevin Dang, D.D.S.

  • General Practice Dentistry
  • Everett, WA
  • NPI 1831127687
  NPD (past) Authorized official

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1235177734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10315 19TH AVE SE",
            "address_2": "STE 102",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982084259",
            "telephone_number": "425-385-3170",
            "fax_number": "425-385-3907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10315 19TH AVE SE",
            "address_2": "STE 102",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982084259",
            "telephone_number": "425-385-3170",
            "fax_number": "425-385-3907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DANG",
        "authorized_official_first_name": "T.",
        "authorized_official_middle_name": "KEVIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-385-3170",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Everett Therapeutic Center, LLC
• Everett Transitional Care Services
• Everett Urological, PLLC. (Everett Urology)
• Everett Vision Therapy
• James Dwight Everett, MA, LMHC
• Evergreen Home Health & Hospice Care, LLC
• Evergreen Neurology & Neurodiagnostic PLLC
• Evergreen Park Professionals
• Evergreen Recovery Centers
• Evergreen Recovery Centers

• General Practice Dentistry in Everett, WA
• Providers in Everett, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.

Verify at the official NPI Registry.