Kimberly Susan Evans, DH

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

Practice address

1050 W Hayward Dr
Mount Vernon, MO 65712-6329

Phone

(417) 466-7196

Fax

(417) 466-4081

NPI assigned

Jul 27, 2022

Last updated

Jul 27, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• J. Warren Hildreth, Jr DDS PC of Missouri

  • General Practice Dentistry
  • Mount Vernon, MO
  • NPI 1952403040
  NPD (past)
• Mid - America Hearing Center, Inc

  • Hearing Instrument Specialist
  • Mount Vernon, MO
  • NPI 1578665550
  NPD (past)

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

{
    "created_epoch": "1658880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658880000000",
    "number": "1245966712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 W HAYWARD DR",
            "city": "MOUNT VERNON",
            "state": "MO",
            "postal_code": "657126329",
            "telephone_number": "417-466-7196",
            "fax_number": "417-466-4081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 W HAYWARD DR",
            "city": "MOUNT VERNON",
            "state": "MO",
            "postal_code": "657126329",
            "telephone_number": "417-466-7196",
            "fax_number": "417-466-4081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "KIMBERLY",
        "middle_name": "SUSAN",
        "name_prefix": "Miss",
        "credential": "DH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-27",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ramonda Lynn Dugas, NP
• Rolando Sy Dy, M.D.
• Lawrence L. Dybedock, M.D.
• David Eden, PHARMACIST
• Ernest Edwin Emmerton III, D.O.
• David Lee Ewing, D.D.S.
• Adam Freitas
• Jill Freitas
• Brooklyn Ruth Fulk, DPT
• Joe A Gardner, MD

• Dental Hygienist in Mount Vernon, MO
• Providers in Mount Vernon, MO by specialty
• Dental Hygienist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2022; 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.