Active NPI
Eager Evans, DDS
- Dentist
- Yuba City, CA
National Provider Identifier
1811064595
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- LCS52777
- Practice address
- 1215 Plumas St
Ste 400
Yuba City, CA 95991-3453 - Phone
- (530) 671-2630
- NPI assigned
- Nov 29, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | LCS52777 | CA | Primary |
Addresses
Primary practice location
1215 Plumas St
Ste 400
Yuba City, CA 95991-3453
Mailing address
1215 Plumas St
Ste 400
Yuba City, CA 95991-3453
Phone (530) 671-2630
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 52777 | Other | CA | DENTAL LICENSE |
Medicare participation
Medicare enrollment files- 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: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160209000045 | CA | Order and Referring Only - Dentist | 0648574897 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCS52777 | CA | MD | Dentist |
| 52777 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1338940800000",
"number": "1811064595",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1215 PLUMAS ST",
"address_2": "STE 400",
"city": "YUBA CITY",
"state": "CA",
"postal_code": "959913453",
"telephone_number": "530-671-2630"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1215 PLUMAS ST",
"address_2": "STE 400",
"city": "YUBA CITY",
"state": "CA",
"postal_code": "959913453",
"telephone_number": "530-671-2630"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "EAGER",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-29",
"last_updated": "2012-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "LCS52777",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL LICENSE",
"identifier": "52777",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Yuba City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2012; 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.