Evan J Short, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

019034032 Issued in IL

Practice address

760 Beloit Rd
Belvidere, IL 61008-1745

Phone

(815) 547-5151

Fax

(815) 547-5336

NPI assigned

Dec 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cornerstar Dental Group and Orthodontics

  • General Practice Dentistry
  • Aurora, CO
  • NPI 1306092747
  NPD (past)
• Rock Canyon Dental Care, LLC

  • General Practice Dentistry
  • Highlands Ranch, CO
  • NPI 1124103957
  NPD (past)

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1861558652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3996 RED CEDAR DR UNIT A3",
            "city": "HIGHLANDS RANCH",
            "state": "CO",
            "postal_code": "801268066",
            "telephone_number": "303-470-9696",
            "fax_number": "216-584-1364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 BELOIT RD",
            "city": "BELVIDERE",
            "state": "IL",
            "postal_code": "610081745",
            "telephone_number": "815-547-5151",
            "fax_number": "815-547-5336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORT",
        "first_name": "EVAN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "DEN.00202905",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "7023",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "DEN.00202905",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019034032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shin S Chen MD LLC
• Shobha S Iyengar, MD SC
• Shopko Stores Operating Co LLC
• Shopko Stores Operating Co. LLC
• Shoptikal LLC
• Joseph Hahn Silbaugh, D.C.
• Mary Simmons, MD
• Smiledentist, PC
• Solcare Medical Transportation
• Eileen A Solis, FNP-BC

• Dentist in Belvidere, IL
• Providers in Belvidere, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.