Jared Dean Evans, D.M.D.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DE00010191 Issued in WA

Practice address

1327 N Stanford LN
Suite B
Liberty Lake, WA 99019-5034

Phone

(509) 891-7070

Fax

(509) 891-4741

NPI assigned

Oct 18, 2006

Last updated

Jul 27, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Healthful Sleep Solutions LLC

  • Customized Equipment (DME)
  • Liberty Lake, WA
  • NPI 1639804974
  NPD Authorized official
• J. Evans, DMD, P.S.

  dba KiDDS Dental

  • Pediatric Dentistry
  • Liberty Lake, WA
  • NPI 1144427964
  NPD (past) Authorized official
• JD Online LLC

  dba Washington Medical Group

  • Multi-Specialty Clinic/Center
  • Liberty Lake, WA
  • NPI 1588408504
  NPD (past) Authorized official

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343347200000",
    "number": "1306927892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1327 N STANFORD LN",
            "address_2": "SUITE B",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990195034",
            "telephone_number": "509-891-7070",
            "fax_number": "509-891-4741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1327 N STANFORD LN",
            "address_2": "SUITE B",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990195034",
            "telephone_number": "509-891-7070",
            "fax_number": "509-891-4741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "JARED",
        "middle_name": "DEAN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2012-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WA",
            "license": "DE00010191",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "DN16714",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5050513",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5048236",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth A Duran, OTRL
• Chase Anthony Earling, PHARMD
• Mathew Edwards
• Barry Ehlert, RPH
• Madhu Enjati, PT
• Evergreen Dermatopathology PLLC
• Evergreen Mental Health LLC
• Isabella Faccone
• Family Home Care Corporation
• Family Home Care Corporation

• Pediatric Dentistry in Liberty Lake, WA
• Providers in Liberty Lake, WA by specialty
• Pediatric Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2012; 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.