Samuel Gene Evans Jr., DDS

Primary specialty

DentistTaxonomy code 122300000X

License

5286 Issued in NC

Practice address

304 Iona St
Fairmont, NC 28340-1618

Phone

(910) 628-7166

Fax

(910) 682-7167

NPI assigned

Feb 26, 2009

Last updated

Feb 26, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fairmont Dental Inc

  • General Practice Dentistry
  • Fairmont, NC
  • NPI 1598800039
  Authorized official Same address or phone

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

{
    "created_epoch": "1235606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235606400000",
    "number": "1710127022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 IONA ST",
            "city": "FAIRMONT",
            "state": "NC",
            "postal_code": "283401618",
            "telephone_number": "910-628-7166",
            "fax_number": "910-682-7167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 IONA ST",
            "city": "FAIRMONT",
            "state": "NC",
            "postal_code": "283401618",
            "telephone_number": "910-628-7166",
            "fax_number": "910-682-7167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "SAMUEL",
        "middle_name": "GENE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-02-26",
        "last_updated": "2009-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "5286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David F Curtis (Future Innovations)
• Kristy Deese, FNP-BC
• Eden Health Care Services Inc
• Aundrea Rae Emanuel, FNP
• Kasey Oxendine Epps, DMD
• Fairmont Area EMS & Rescue
• Fairmont Dental Inc
• Fairmont Drug Company LLC (Fairmont Drug Company)
• Fairmont Eye Clinic OD PLLC
• Fairmont Opco, LLC (Greenbrier of Fairmont)

• Dentist in Fairmont, NC
• Providers in Fairmont, NC by specialty
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2009; 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.