Richard B Evans, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

31914 Issued in CA

Practice address

8530 La Mesa Blvd Ste 204
La Mesa, CA 91942-0966

Phone

(619) 494-2492

Fax

(619) 460-0700

NPI assigned

Oct 18, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

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.

• Richard B. Evans, D.D.S., Inc.

  • Dental Clinic/Center
  • La Mesa, CA
  • NPI 1497048664

  General Practice

  Medicare reassignment NPD Authorized official
• San Diego Dental Sleep Therapy, LLC

  • Durable Medical Equipment & Medical Supplies
  • La Mesa, CA
  • NPI 1811259856
  NPD (past) Authorized official

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1780673202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8530 LA MESA BLVD STE 204",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919420966",
            "telephone_number": "619-494-2492",
            "fax_number": "619-460-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8530 LA MESA BLVD STE 204",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919420966",
            "telephone_number": "619-494-2492",
            "fax_number": "619-460-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "RICHARD",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "31914",
            "primary": false
        },
        {
            "code": "1223X2210X",
            "taxonomy_group": "",
            "desc": "Dentist, Orofacial Pain",
            "state": "CA",
            "license": "31914",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "31914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leticia Estrella
• Samuel O Etchie, M.D.
• Michelle Etherington, LVN
• Caitlin Eubanks, LCSW
• Keane Evangelista
• Evolve Growth Initiatives LLC
• Evolve Growth Initiatives LLC
• Evolve Rehab & Performance
• Excel Home Health
• Jerry M Fabrikant, D.P.M.

• General Practice Dentistry in La Mesa, CA
• Providers in La Mesa, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2021; 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.

Verify at the official NPI Registry.