Evan Pedersen DMD, PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

EVAN PEDERSEN DMD, PLLC

Doing business as

Oris Dental Studio

Practice address

18101 W State Highway 71 Ste 100
Austin, TX 78738-0017

Phone

(512) 777-0866

NPI assigned

Nov 9, 2022

Last updated

Nov 9, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Evan PedersenNPI 1043552516

Title

Owner

Phone

(815) 975-8758

Specialties & licenses 1

Addresses

Other names 1

• Oris Dental Studio Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Evan Pedersen, D.M.D.

  • General Practice Dentistry
  • Ocala, FL
  • NPI 1043552516
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1667952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667952000000",
    "number": "1962110817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6726 LANCRET HILL DR # B",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787454717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18101 W STATE HIGHWAY 71 STE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787380017",
            "telephone_number": "512-777-0866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVAN PEDERSEN DMD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-09",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A",
        "authorized_official_last_name": "PEDERSEN",
        "authorized_official_first_name": "EVAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-975-8758"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oris Dental Studio",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Virginia M.T. Eubanks, M.D.
• David Wayne Euers, D.D.S.
• Vadine Eugene, MD
• Heather Latiolais Eure, IBCLC
• Emily Eusanio
• Laura Evanoff, LCSW
• Evans Family Dental, PA
• Evans Marriage Family Therapy Inc. (Nicole Evans Therapy)
• Brandon Evans-Clements, LPC
• Angel Renee Evans

• Dental Clinic/Center in Austin, TX
• Providers in Austin, TX by specialty
• Dental Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2022; 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.