NPIMap

Organization Active NPI

Evergreen Family Dentistry

  • General Practice Dentistry
  • Yreka, CA
National Provider Identifier
1881806339
Registry record updated Jul 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
38440 Issued in CA
Legal business name
EVERGREEN FAMILY DENTISTRY
Practice address
310 Evergreen LN
Yreka, CA 96097-3203
Phone
(530) 842-2558
Fax
(530) 842-9011
NPI assigned
May 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2007

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

Authorized official

Name
Dr. Randy Dee Krant, DDSNPI 1497043038
Title
Partner
Phone
(530) 842-2558

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
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 38440 CA Primary

Addresses

Primary practice location

310 Evergreen LN
Yreka, CA 96097-3203

Mailing address

310 Evergreen LN
Yreka, CA 96097-3203
Phone (530) 842-2558

Other names 1

  • Randy D. Krant, DDS Other name

National Provider Directory

National Provider Directory

Locations

310 Evergreen Ln
Yreka, CA 96097
Phone (530) 842-2558

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": "1178323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184803200000",
    "number": "1881806339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 EVERGREEN LN",
            "city": "YREKA",
            "state": "CA",
            "postal_code": "960973203",
            "telephone_number": "530-842-2558",
            "fax_number": "530-842-9011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 EVERGREEN LN",
            "city": "YREKA",
            "state": "CA",
            "postal_code": "960973203",
            "telephone_number": "530-842-2558",
            "fax_number": "530-842-9011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-05",
        "last_updated": "2007-07-19",
        "status": "A",
        "authorized_official_last_name": "KRANT",
        "authorized_official_first_name": "RANDY",
        "authorized_official_middle_name": "DEE",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "530-842-2558",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "38440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Randy D. Krant, DDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Yreka, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2007; 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.