NPIMap

Organization Active NPI

Richard a. Evanseck, DDS,PC

  • General Practice Dentistry
  • Marion, IN
National Provider Identifier
1922017169
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12009660 Issued in IN
Legal business name
RICHARD A. EVANSECK, DDS,PC
Practice address
1007 N Western Ave
Marion, IN 46952-2503
Phone
(765) 664-2115
Fax
(765) 664-2124
NPI assigned
Aug 5, 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. Richard Andrew Evanseck, DDSNPI 1033128277
Title
Dentist
Phone
(765) 664-2115

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 SINGLE SPECIALTY GROUP 1223G0001X 12009660 IN Primary

Addresses

Primary practice location

1007 N Western Ave
Marion, IN 46952-2503

Mailing address

1007 N Western Ave
Marion, IN 46952-2503
Phone (765) 664-2115

National Provider Directory

National Provider Directory

Locations

1007 N Western Ave
Marion, IN 46952
Phone (765) 664-2115

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": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1922017169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 N WESTERN AVE",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469522503",
            "telephone_number": "765-664-2115",
            "fax_number": "765-664-2124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 N WESTERN AVE",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469522503",
            "telephone_number": "765-664-2115",
            "fax_number": "765-664-2124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD A. EVANSECK, DDS,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EVANSECK",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "765-664-2115",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12009660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, IN

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.