Provider Demographics
NPI:1013117274
Name:EVANS, JEFFREY A (DDS)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:A
Last Name:EVANS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 W CRAWFORD ST
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-3203
Mailing Address - Country:US
Mailing Address - Phone:419-422-9034
Mailing Address - Fax:419-422-9035
Practice Address - Street 1:306 NE BLAKE ST STE 1
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-5328
Practice Address - Country:US
Practice Address - Phone:479-273-7993
Practice Address - Fax:479-273-3158
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-24
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR44991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty