Individual provider Active NPI

Erik William Evans, DDS, MD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Cincinnati, OH
National Provider Identifier
1740356534
Registry record updated Feb 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
35.087935 Issued in OH
Practice address
222 Piedmont Ave
Ste. 7300
Cincinnati, OH 45219-2489
Phone
(513) 475-8787
Fax
(513) 475-7348
NPI assigned
Nov 26, 2006
Last updated
Feb 26, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 20929 OH
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 30.020929 OH
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 35.087935 OH Primary
Surgery Physician 208600000X 35.087935 OH

Addresses

Primary practice location

222 Piedmont Ave
Ste. 7300
Cincinnati, OH 45219-2489

Mailing address

PO Box 630579
Cincinnati, OH 45263-0579
Phone (513) 585-5506

Other identifiers 1

IdentifierTypeStateIssuer
2666959MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090209000109 OH Practitioner - Maxillofacial SurgeryPractitioner - Oral Surgery 3072678010 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
20929OHMDOral and Maxillofacial Surgery (Dentist)
30.020929OHMDOral & Maxillofacial Surgery (D.M.D.)
35.087935OHMDOral & Maxillofacial Surgery (D.M.D.)

Practice roles

OrganizationSpecialtyStatusNew patients
University Surgical-Dental Associates, LLC Oral and Maxillofacial Surgery CurrentSince Mar 1, 2012 Accepting new patients
University of Cincinnati Physicians Company, LLC Surgery CurrentSince Nov 1, 2011 Accepting new patients
Ohio State Dental Faculty Practice Inc Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

222 Piedmont Ave
Ste 7300
Cincinnati, OH 45219
Phone (513) 475-8783

3188 Bellevue Ave
Cincinnati, OH 45219
Phone (513) 558-5281

70 Damon Rd
Cincinnati, OH 45218
Phone (513) 605-1000

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1164499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519603200000",
    "number": "1740356534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 630579",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452630579",
            "telephone_number": "513-585-5506",
            "fax_number": "513-585-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 PIEDMONT AVE",
            "address_2": "STE. 7300",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452192489",
            "telephone_number": "513-475-8787",
            "fax_number": "513-475-7348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "ERIK",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "DDS, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-26",
        "last_updated": "2018-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OH",
            "license": "20929",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "OH",
            "license": "30.020929",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "OH",
            "license": "35.087935",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "35.087935",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2666959",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.