NPIMap

Organization Active NPI

Jaime V. Evangelista Jr, D.M.D, Inc.

  • General Practice Dentistry
  • Hayward, CA
National Provider Identifier
1851476766
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
37103 Issued in CA
Legal business name
JAIME V. EVANGELISTA JR, D.M.D, INC.
Practice address
24901 Santa Clara St
Suite B-2
Hayward, CA 94544-2147
Phone
(510) 887-6835
Fax
(510) 887-2872
NPI assigned
Oct 26, 2006
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. Jaime Victores Evangelista Jr., D.M.D.
Title
Dentist
Phone
(510) 887-6835

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 37103 CA Primary

Addresses

Primary practice location

24901 Santa Clara St
Suite B-2
Hayward, CA 94544-2147

Mailing address

24901 Santa Clara St
Suite B-2
Hayward, CA 94544-2147
Phone (510) 887-6835

Other names 1

  • Gateway Plaza Dental Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dr Jaime V Evangelista Jr DMD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

24901 Santa Clara St
Ste B2
Hayward, CA 94544
Phone (510) 887-6835

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1851476766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24901 SANTA CLARA ST",
            "address_2": "SUITE B-2",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945442147",
            "telephone_number": "510-887-6835",
            "fax_number": "510-887-2872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24901 SANTA CLARA ST",
            "address_2": "SUITE B-2",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945442147",
            "telephone_number": "510-887-6835",
            "fax_number": "510-887-2872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAIME V. EVANGELISTA JR, D.M.D, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EVANGELISTA",
        "authorized_official_first_name": "JAIME",
        "authorized_official_middle_name": "VICTORES",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "510-887-6835",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "37103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gateway Plaza Dental Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hayward, CA

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.