Active NPI
Nicholas Evans, DDS
- Pediatric Dentistry
- Colorado Springs, CO
National Provider Identifier
1922747849
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DEN.00205825
- Practice address
- 5430 E Woodmen Rd
Colorado Springs, CO 80920-8067 - Phone
- (719) 424-4668
- NPI assigned
- May 31, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 22DI03021100 | NJ | |
| Pediatric Dentistry | 1223P0221X | DEN.00205825 | CO | Primary |
Addresses
Primary practice location
5430 E Woodmen Rd
Colorado Springs, CO 80920-8067
Mailing address
440 Newcastle St
Thousand Oaks, CA 91361-1338
Other practice location 1
66 Somme St
Newark, NJ 07105-3612
Phone (973) 578-8788
Other practice location 2
440 Newcastle St
Thousand Oaks, CA 91361-1338
Phone (805) 728-5108
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DEN.00205825 | CO | MD | Pediatric Dentist |
| 22DI03021100 | NJ | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Child Smiles Spec LLC | Past | Accepting new patients | |
| Corban Stettler, DDS PC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Dentist
- Colorado Springs, CO
- NPI 1700275062
-
dba Childsmiles
- Orthodontics and Dentofacial Orthopedics Dentistry
- Newark, NJ
- NPI 1184099251
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1653955200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1741219200000",
"number": "1922747849",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "440 NEWCASTLE ST",
"city": "THOUSAND OAKS",
"state": "CA",
"postal_code": "913611338"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5430 E WOODMEN RD",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809208067",
"telephone_number": "719-424-4668"
}
],
"practiceLocations": [
{
"address_1": "66 Somme St",
"address_purpose": "LOCATION",
"city": "Newark",
"state": "NJ",
"postal_code": "071053612",
"country_code": "US",
"telephone_number": "973-578-8788",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "440 Newcastle St",
"address_purpose": "LOCATION",
"city": "Thousand Oaks",
"state": "CA",
"postal_code": "913611338",
"country_code": "US",
"telephone_number": "805-728-5108",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EVANS",
"first_name": "NICHOLAS",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-05-31",
"last_updated": "2025-03-06",
"certification_date": "2025-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NJ",
"license": "22DI03021100",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CO",
"license": "DEN.00205825",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.