Dr. Evan G. Long

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

6693 Issued in NC

Legal business name

DR. EVAN G. LONG

Practice address

5641 Poplar Tent Rd
Suite 201
Concord, NC 28027-7533

Phone

(704) 795-2300

Fax

(704) 795-2301

NPI assigned

Jul 29, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Evan G. Long, DDS

Title

Owner

Phone

(704) 795-2300

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190678400000",
    "number": "1386659258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5641 POPLAR TENT RD",
            "address_2": "SUITE 201",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280277533",
            "telephone_number": "704-795-2300",
            "fax_number": "704-795-2301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5641 POPLAR TENT RD",
            "address_2": "SUITE 201",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280277533",
            "telephone_number": "704-795-2300",
            "fax_number": "704-795-2301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. EVAN G. LONG",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-29",
        "last_updated": "2007-09-25",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "EVAN",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-795-2300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NC",
            "license": "6693",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "799002T",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ayana Juanique Dowe
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• Dr. Gregory C. Gell, DDS
• Dr. Nikki E. Jones, DDS, PA
• Dr. Quinn Ear, Nose & Throat, PC
• Dr. Sanchez & Associates, II
• Michelle Kristen Drains, ND

• Pediatric Dentistry in Concord, NC
• Providers in Concord, NC by specialty
• Pediatric Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2007; 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.