Evan Coravos, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

14791 Issued in MA

Practice address

75 Arcand Dr
Lowell, MA 01810

Phone

(978) 458-4921

Fax

(978) 458-8860

NPI assigned

Sep 20, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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 MA

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

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376641050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 ARCAND DR",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "01852",
            "telephone_number": "978-458-4921",
            "fax_number": "978-458-8864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 ARCAND DR",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "01810",
            "telephone_number": "978-458-4921",
            "fax_number": "978-458-8860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORAVOS",
        "first_name": "EVAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "14791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol A Cookingham, D.V.M.
• Bree Cooley
• Reide Cooper
• Sean Wesley Cooper, LCSW
• Maryalice Coraccio, B.S.
• Christine Anne Corbin, MS
• Briana Cordova, LCSW
• Emily Cormier, RPH
• Concettina M Cormio
• Cornerstone Transit LLC

• General Practice Dentistry in Lowell, MA
• Providers in Lowell, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.