Active NPI
Thomas Bart Evans, D.D.S.
- General Practice Dentistry
- Fremont, CA
National Provider Identifier
1891895504
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 24543
- Practice address
- 39783 Paseo Padre Pkwy
Fremont, CA 94538-2926 - Phone
- (510) 656-8662
- Fax
- (510) 656-8951
- NPI assigned
- Sep 23, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 24543 | CA | Primary |
Addresses
Primary practice location
39783 Paseo Padre Pkwy
Fremont, CA 94538-2926
Mailing address
39783 Paseo Padre Pkwy
Fremont, CA 94538-2926
Phone (510) 656-8662
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158969600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1891895504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "39783 PASEO PADRE PKWY",
"city": "FREMONT",
"state": "CA",
"postal_code": "945382926",
"telephone_number": "510-656-8662",
"fax_number": "510-656-8951"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "39783 PASEO PADRE PKWY",
"city": "FREMONT",
"state": "CA",
"postal_code": "945382926",
"telephone_number": "510-656-8662",
"fax_number": "510-656-8951"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "THOMAS",
"middle_name": "BART",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "24543",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fremont, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.