NPIMap

Organization Active NPI

Charles L. Evans DDS SC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Waukesha, WI
National Provider Identifier
1841333564
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
0379G Issued in WI
Legal business name
CHARLES L. EVANS DDS SC
Practice address
2140 W Saint Paul Ave Ste a
Waukesha, WI 53188-5905
Phone
(262) 547-2827
Fax
(262) 547-1269
NPI assigned
Feb 14, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Charles L EvansNPI 1649313453
Title
President
Phone
(262) 547-2827

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 0379G WI Primary

Addresses

Primary practice location

2140 W Saint Paul Ave Ste a
Waukesha, WI 53188-5905

Mailing address

2140 W Saint Paul Ave Ste a
Waukesha, WI 53188-5905
Phone (262) 547-2827

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841333564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2140 W SAINT PAUL AVE STE A",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531885905",
            "telephone_number": "262-547-2827",
            "fax_number": "262-547-1269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2140 W SAINT PAUL AVE STE A",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531885905",
            "telephone_number": "262-547-2827",
            "fax_number": "262-547-1269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES L. EVANS DDS SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "262-547-2827",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "WI",
            "license": "0379G",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.