Individual provider Active NPI

William Walker Evans, D.M.D., M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Redding, CA
National Provider Identifier
1740387422
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
A 55473 Issued in CA
Practice address
2710 Eureka Way
Suite 3
Redding, CA 96001-0230
Phone
(530) 241-6374
Fax
(530) 241-5140
NPI assigned
Sep 17, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X A 55473 CA Primary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 17716 MA
Oral and Maxillofacial Surgery (Dentist) 1223S0112X OMS 20 CA

Addresses

Primary practice location

2710 Eureka Way
Suite 3
Redding, CA 96001-0230

Mailing address

2710 Eureka Way
Suite 3
Redding, CA 96001-0230
Phone (530) 241-6374

Other identifiers 1

IdentifierTypeStateIssuer
B89020-01MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Apr 4, 2018 through Apr 4, 2028

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20CAMDProfessional Counselor
A 55473CAMDOral and Maxillofacial Surgery (Dentist)
17716MAMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Richard a. Look, D.D.S., Inc. Oral and Maxillofacial Surgery 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, 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": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740387422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2710 EUREKA WAY",
            "address_2": "SUITE 3",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960010230",
            "telephone_number": "530-241-6374",
            "fax_number": "530-241-5140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2710 EUREKA WAY",
            "address_2": "SUITE 3",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960010230",
            "telephone_number": "530-241-6374",
            "fax_number": "530-241-5140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "WILLIAM",
        "middle_name": "WALKER",
        "name_prefix": "Dr.",
        "credential": "D.M.D., M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "A 55473",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MA",
            "license": "17716",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "OMS 20",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B89020-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

Verify at the official NPI Registry.