Evans, Jared Dean

Evans, Jared Dean is an sole proprietor health care provider with primary practice located at 1327 N Stanford Ln Suite B, Liberty Lake WA 99019-5034. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Evans, Jared Dean can be contacted via phone (509) 891-7070.

Contact Information

Primary practice address
1327 N Stanford Ln Suite B Liberty Lake WA 99019-5034
Phone: (509) 891-7070
Fax: (509) 891-4741
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X DE00010191 Washington
Dental Providers / Pediatric Dentistry 1223P0221X DN16714 Florida

Profile Details

NPI number 1306927892
LBN Legal business name Evans, Jared Dean
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 18th, 2006
Last updated Jul 27th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306927892 NPPES
Washington MEDICAID 5048236
Washington MEDICAID 5050513

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