Individual provider Active NPI

L. Cory Evans, D.M.D.

  • General Practice Dentistry
  • Salt Lake City, UT
National Provider Identifier
1811093081
Registry record updated Jun 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
89-144422-9923 Issued in UT
Practice address
3640 South Highland Dr.
Suite 6
Salt Lake City, UT 84106
Phone
(801) 278-9911
Fax
(801) 278-9913
NPI assigned
Sep 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 89-144422-9923 UT Primary

Addresses

Primary practice location

3640 South Highland Dr.
Suite 6
Salt Lake City, UT 84106

Mailing address

3640 South Highland Dr.
Suite 6
Salt Lake City, UT 84106
Phone (801) 278-9911

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address CEVANS297033@DIRECT.MED.UTAH.EDU Direct University of Utah

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
89-144422-9923UTMDGeneral Practice Dentistry

Interoperability endpoints

  • Direct secure messaging: cevans297033@direct.med.utah.edu

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654646400000",
    "number": "1811093081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3640 SOUTH HIGHLAND DR.",
            "address_2": "SUITE 6",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84106",
            "telephone_number": "801-278-9911",
            "fax_number": "801-278-9913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3640 SOUTH HIGHLAND DR.",
            "address_2": "SUITE 6",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84106",
            "telephone_number": "801-278-9911",
            "fax_number": "801-278-9913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "L.",
        "middle_name": "CORY",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "89-144422-9923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "CEVANS297033@DIRECT.MED.UTAH.EDU",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2022; 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.