Bryce Orrick Evans, DMD

Individual provider Active NPI General Practice Dentistry · Seaside, OR

NPI 1477545424 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1477545424
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
D8333 (OR)
Practice address
729 S Holladay Dr
Seaside, OR 97138-6606
Phone
(503) 738-6520
Fax
(503) 738-6556
NPI assigned
Aug 16, 2005
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
D8333ORMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Seaside Dental Clinic General Practice Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D8333 OR Yes

Addresses

Primary practice location

729 S Holladay Dr
Seaside, OR 97138-6606

Mailing address

729 S Holladay Dr
Seaside, OR 97138-6606
Phone (503) 738-6520

Other providers in Seaside, OR

All providers in Seaside, OR · General Practice Dentistry in Oregon

Sources for this page

Verify at the official NPI Registry.