Provider Demographics
NPI:1023201688
Name:J. TAYLOR EVANS D.D.S., P.C.
Entity Type:Organization
Organization Name:J. TAYLOR EVANS D.D.S., P.C.
Other - Org Name:SMILEXPRESS ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:TAYLOR
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS PC
Authorized Official - Phone:214-646-0870
Mailing Address - Street 1:4222 TRINITY MILLS RD STE 250
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75287-7655
Mailing Address - Country:US
Mailing Address - Phone:214-646-0870
Mailing Address - Fax:214-646-0875
Practice Address - Street 1:4222 TRINITY MILLS RD STE 250
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75287-7655
Practice Address - Country:US
Practice Address - Phone:214-646-0870
Practice Address - Fax:214-646-0875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-27
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX76831223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty