Individual provider Active NPI

Geoffrey Charles Evans, D.D.S

  • General Practice Dentistry
  • Canonsburg, PA
National Provider Identifier
1639622624
Registry record updated Jul 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS040984 Issued in PA
Practice address
100 Houston SQ
Suit 1a
Canonsburg, PA 15317-1469
Phone
(724) 746-5330
NPI assigned
Jul 26, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS040984 PA Primary

Addresses

Primary practice location

100 Houston SQ
Suit 1a
Canonsburg, PA 15317-1469

Mailing address

100 Houston SQ
Suit 1a
Canonsburg, PA 15317-1469
Phone (724) 746-5330

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DS040984PAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Robert Evans DDS General Practice Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1469491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469491200000",
    "number": "1639622624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HOUSTON SQ",
            "address_2": "SUIT 1A",
            "city": "CANONSBURG",
            "state": "PA",
            "postal_code": "153171469",
            "telephone_number": "724-746-5330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HOUSTON SQ",
            "address_2": "SUIT 1A",
            "city": "CANONSBURG",
            "state": "PA",
            "postal_code": "153171469",
            "telephone_number": "724-746-5330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "GEOFFREY",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-26",
        "last_updated": "2016-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS040984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canonsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2016; 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.