Active NPI
Gerald Holderith Evans, DDS
- Periodontics
- New Orleans, LA
National Provider Identifier
1770765406
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 3279
- Practice address
- 1100 Florida Ave
New Orleans, LA 70119-2799 - Phone
- (504) 941-8277
- NPI assigned
- Dec 5, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 3279 | LA | Primary |
Addresses
Primary practice location
1100 Florida Ave
New Orleans, LA 70119-2799
Mailing address
5121 Craig Ave
Kenner, LA 70065-3215
Phone (504) 887-1479
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181211003258 | LA | Order and Referring Only - Dentist | 1658615075 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3279 | LA | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196812800000",
"number": "1770765406",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5121 CRAIG AVE",
"city": "KENNER",
"state": "LA",
"postal_code": "700653215",
"telephone_number": "504-887-1479"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 FLORIDA AVE",
"city": "NEW ORLEANS",
"state": "LA",
"postal_code": "701192799",
"telephone_number": "504-941-8277"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "GERALD",
"middle_name": "HOLDERITH",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-12-05",
"last_updated": "2007-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "LA",
"license": "3279",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Orleans, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.