Individual provider Active NPI

Krystal Brooke Evans, R.D.H., R.D.A.

  • Dental Hygienist
  • Houston, TX
National Provider Identifier
1245654243
Registry record updated Feb 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
18757 Issued in TX
Practice address
9113 Stella Link Rd Ste C
Houston, TX 77025-3931
Phone
(713) 375-1777
Fax
(832) 383-0022
NPI assigned
Feb 11, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 18757 TX Primary
Dental Assistant 126800000X 36830 TX

Addresses

Primary practice location

9113 Stella Link Rd Ste C
Houston, TX 77025-3931

Mailing address

9113 Stella Link Rd Ste C
Houston, TX 77025-3931
Phone (713) 375-1777

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

LicenseStateTypeSpecialty
18757TXMDDental Hygienist
36830TXMDDental Assistant

NPI Registry JSON

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

{
    "created_epoch": "1392076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392076800000",
    "number": "1245654243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9113 STELLA LINK RD STE C",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770253931",
            "telephone_number": "713-375-1777",
            "fax_number": "832-383-0022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9113 STELLA LINK RD STE C",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770253931",
            "telephone_number": "713-375-1777",
            "fax_number": "832-383-0022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "KRYSTAL",
        "middle_name": "BROOKE",
        "name_prefix": "Miss",
        "credential": "R.D.H., R.D.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-11",
        "last_updated": "2014-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "TX",
            "license": "18757",
            "primary": true
        },
        {
            "code": "126800000X",
            "taxonomy_group": "",
            "desc": "Dental Assistant",
            "state": "TX",
            "license": "36830",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2014; 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.