Individual provider Active NPI

Nicholas Evans, DDS

  • Pediatric Dentistry
  • Colorado Springs, CO
National Provider Identifier
1922747849
Registry record updated Mar 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DEN.00205825 Issued in CO
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

Updated by the provider on Mar 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
DEN.00205825COMDPediatric Dentist
22DI03021100NJMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Child Smiles Spec LLC Past Accepting new patients
Corban Stettler, DDS PC PastSince Mar 11, 2025 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.

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.

Verify at the official NPI Registry.