Evan Riley, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

6752 Issued in LA

Practice address

4040 Lonesome Rd
Mandeville, LA 70448

Phone

(985) 626-5030

NPI assigned

May 25, 2017

Sex

Male

Sole proprietor

No

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

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Covington Family Dentistry, LLC

  • General Practice Dentistry
  • Covington, LA
  • NPI 1447107602
  NPD Authorized official
• Louisiana Dental Professionals, Donovan Dronet, DDS, a Professional de

  • General Practice Dentistry
  • Mandeville, LA
  • NPI 1225369242
  NPD (past)

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

{
    "created_epoch": "1495670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572998400000",
    "number": "1316475080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 TANAGER DR",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704486100",
            "telephone_number": "504-756-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 LONESOME RD",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "70448",
            "telephone_number": "985-626-5030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Lapalco Blvd Ste B",
            "address_purpose": "LOCATION",
            "city": "Gretna",
            "state": "LA",
            "postal_code": "700567372",
            "country_code": "US",
            "telephone_number": "504-392-4384",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RILEY",
        "first_name": "EVAN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-25",
        "last_updated": "2019-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "LA",
            "license": "6752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Richard, D.O.
• Mark Sebastian Richard, D.C.
• Faith S. Rickert, OT
• Timothy L Riddell, MD
• Karen Riehm, NP
• Shannon Coyle Riordan, O.T.
• Elizabeth Jane Rivault, PA-C
• Gwendolyn Rivere
• Christopher J Riviere, PHARM. D.
• RM Lafleur Enterprises LLC

• Dentist in Mandeville, LA
• Providers in Mandeville, LA by specialty
• Dentist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.