Individual provider Active NPI

Frank J Evans, DDS

  • Dentist
  • Fort Gibson, OK
National Provider Identifier
1942352919
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4359 Issued in OK
Practice address
802 S Lee
Fort Gibson, OK 74434-0206
Phone
(918) 478-2341
Fax
(918) 478-2341
NPI assigned
Jan 18, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 4359 OK Primary

Addresses

Primary practice location

802 S Lee
Fort Gibson, OK 74434-0206

Mailing address

PO Box 206
Fort Gibson, OK 74434-0206
Phone (918) 478-2341

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160121000229 OK Order and Referring Only - DentistPractitioner - Dentist 1254634595

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4359OKMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Frank J Evans, DDS, PLLC Dentist Current Accepting new patients

Locations

802 S Lee St
Fort Gibson, OK 74434
Phone (918) 478-2341

Organizations & group practices 1

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": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942352919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 206",
            "city": "FORT GIBSON",
            "state": "OK",
            "postal_code": "744340206",
            "telephone_number": "918-478-2341",
            "fax_number": "918-478-2341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 S LEE",
            "city": "FORT GIBSON",
            "state": "OK",
            "postal_code": "744340206",
            "telephone_number": "918-478-2341",
            "fax_number": "918-478-2341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "FRANK",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "4359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Gibson, OK

Sources for this page

Verify at the official NPI Registry.