Clora Jamie O'Reilly Evans, DMD

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

OR-604-21 Issued in MS

Practice address

2300 N Hills St Ste B
Meridian, MS 39305-2633

Phone

(769) 249-0001

NPI assigned

Aug 7, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Wgo Dental, LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Jackson, MS
  • NPI 1912623141

  Orthodontics and Dentofacial Orthopedics

  NPD Authorized official

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

{
    "created_epoch": "1565136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632441600000",
    "number": "1740835529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 WIMBLEDON DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392112443",
            "telephone_number": "601-594-9202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 N HILLS ST STE B",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393052633",
            "telephone_number": "769-249-0001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "CLORA",
        "middle_name": "JAMIE O'REILLY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-07",
        "last_updated": "2021-09-24",
        "certification_date": "2021-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "D.0006692-C1",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MS",
            "license": "OR-604-21",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elise D Ethridge, DPT
• Jennifer T Eubanks, M.D.
• Joseph Whatley Eubanks
• Robert Ira Eubanks, M.D.
• Evans Optical LLC
• Kelly Ann Evans, FNP-BC
• Tonya Evans
• Valerie Nicole Evans, M.D.
• Caroline Cheatham Everett, NP
• Thurman Keith Everett, M.D.

• All providers in Meridian, MS
• Orthodontics and Dentofacial Orthopedics Dentistry in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2021; 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.