Organization Active NPI

Richard B. Evans, D.D.S., Inc.

  • Dental Clinic/Center
  • La Mesa, CA
National Provider Identifier
1497048664
Registry record updated Jun 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
31914 Issued in CA
Legal business name
RICHARD B. EVANS, D.D.S., INC.
Practice address
8530 La Mesa Blvd Ste 204
La Mesa, CA 91942-0966
Phone
(619) 494-2492
Fax
(619) 460-0707
NPI assigned
May 22, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2026

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

Authorized official

Name
Dr. Richard B. Evans, D.D.S.NPI 1780673202
Title
President
Phone
(760) 468-1828

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X
Orofacial Pain DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X2210X
Dental HygienistGroup: 193200000X MULTI-SPECIALTY GROUP 124Q00000X
Dental Clinic/Center 261QD0000X 31914 CA Primary

Addresses

Primary practice location

8530 La Mesa Blvd Ste 204
La Mesa, CA 91942-0966

Mailing address

8530 La Mesa Blvd Ste 204
La Mesa, CA 91942-0966
Phone (619) 494-2492

Other names 1

  • Summit Dental of La Mesa Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170509000457 CA Part B Supplier - Clinic/Group Practice 9133348527 Receives reassigned benefits from 1 practitioner
Practice locations: La Mesa, CA

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1306022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781136000000",
    "number": "1497048664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8530 LA MESA BLVD STE 204",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919420966",
            "telephone_number": "619-494-2492",
            "fax_number": "619-460-0707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8530 LA MESA BLVD STE 204",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919420966",
            "telephone_number": "619-494-2492",
            "fax_number": "619-460-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD B. EVANS, D.D.S., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-22",
        "last_updated": "2026-06-11",
        "certification_date": "2026-06-11",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-468-1828",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X2210X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orofacial Pain",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dental Hygienist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": "31914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Summit Dental of La Mesa",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Summit Dental of La Mesa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in La Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.