Provider Demographics
NPI:1396888707
Name:EVERTON, ANA-CLAUDIA (DDS)
Entity type:Individual
Prefix:DR
First Name:ANA-CLAUDIA
Middle Name:
Last Name:EVERTON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2802 AVONDALE DR
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-1907
Mailing Address - Country:US
Mailing Address - Phone:832-846-3241
Mailing Address - Fax:
Practice Address - Street 1:2802 AVONDALE DR
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-1907
Practice Address - Country:US
Practice Address - Phone:832-846-3241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX200551223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist