Evan Roberts, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

27079 Issued in TX

Practice address

Wilford Hall Ambulatory Surgical Center
1100 Wilford Hall Loop
Jbsa Lackland, TX 78236

Phone

(210) 539-7036

NPI assigned

Aug 19, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1313712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1821378084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "WILFORD HALL AMBULATORY SURGICAL CENTER",
            "address_2": "1100 WILFORD HALL LOOP",
            "city": "JBSA LACKLAND",
            "state": "TX",
            "postal_code": "78236",
            "telephone_number": "210-539-7036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WILFORD HALL AMBULATORY SURGICAL CENTER",
            "address_2": "1100 WILFORD HALL LOOP",
            "city": "JBSA LACKLAND",
            "state": "TX",
            "postal_code": "78236",
            "telephone_number": "210-539-7036"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4102 Pinion Dr",
            "address_purpose": "LOCATION",
            "city": "Usaf Academy",
            "state": "CO",
            "postal_code": "808402502",
            "country_code": "US",
            "telephone_number": "719-333-5477",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "606 Fisher St",
            "address_2": "81 Dental Squadron/SGD",
            "address_purpose": "LOCATION",
            "city": "Keesler AFB",
            "state": "MS",
            "postal_code": "395342513",
            "country_code": "US",
            "telephone_number": "228-376-0511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "EVAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-19",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "27079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zoe Ring, DMD
• Sarah Michelle Ringdahl, DMD
• Nikaury Rivera Antongiorgi, MD
• Steven Thomas Rivera Jr., DO
• Cecil Lynn Roberts Jr., MD
• Jared Eldon Roberts, M.D.
• Brenda Patricia Robinson, FNP
• Anna Maria Rocha, FNP-C
• Nathan Richard Rocha, PA-C
• Ethan Roderick

• Dentist in Jbsa Lackland, TX
• Providers in Jbsa Lackland, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2024; 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.