DR. BRIAN DAVID EVANS (NPI# 1114229317) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114229317 |
| Entity Type | Individual |
| Full Name | DR. BRIAN DAVID EVANS |
| Credential | DMD |
| Practice Address |
Uss Carl Vinson Cvn70 Unit 1000111 Box 1770 Fpo AP 96629 |
| Mailing Address |
4796 Panorama Dr San Diego CA 92116-1239 |
| Practice Telephone | 6195454814 |
| Mailing Telephone | (208) 757-0787 |
| Enumeration Date | 2010-11-22 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
61230 | CA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | DENTAL LICENSE | 61230 | 01 |
| GENERAL ANESTHESIA PERMIT | GA1863 | 01 | |
| DEA | FE7068201 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4125 Sorrento Valley Blvd Ste D, San Diego, CA 921211423 | 8589972701 | |
| H100 Santa Maargarita Road, Marine Coprs Base Camp Pendleton, CA 92055 | 7607251200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124336128 | Brian Edwards Evans | Dentist | 5220 Neil Rd., 100, Reno, NV 89502 | 2010-09-24 |
| 1932159977 | Brian N Evans | Plastic Surgery | 7325 Medical Center Dr Ste 304, West Hills, CA 91307 | 2006-05-11 |
| 1649883919 | Brian Evans | Pharmacist | 153 W Lincoln St, Augusta, WI 54722-9152 | 2020-08-26 |
| 1417583212 | Brian Richard Evans | Counselor | 15655 W Roosevelt St Ste 220, Goodyear, AZ 85338-9306 | 2020-03-12 |
| 1235775420 | Brian Anthony Evans | Counselor | 2202 N 1st St, San Jose, CA 95131-2007 | 2019-11-22 |
| 1154883023 | Brian Thomas Evans | Radiology | 1070 N Cherry St, Tulare, CA 93274 | 2019-04-01 |
| 1700180254 | Brian Christopher Evans | Physician Assistant | 270 Chastain Rd Nw, Kennesaw, GA 30144-3012 | 2010-12-27 |
| 1417275553 | Brian Evans | Anesthesiology | 842 E Main St, Medford, OR 97504-7134 | 2010-05-13 |
| 1811131550 | Brian Taylor Evans | Psychologist | 2542 Ne Courtney Dr, Bend, OR 97701-7685 | 2009-04-24 |
| 1760532725 | Brian Evans | Dentist | 290 Springfield Dr, Suite 130, Bloomingdale, IL 60108-2214 | 2007-01-11 |
| Street Address |
USS CARL VINSON CVN70 UNIT 1000111 BOX 1770 |
| City | FPO |
| State | AP |
| Zip Code | 96629 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699188391 | Paul Michael Bucking | Student in an Organized Health Care Education/Training Program | Uss Carl Vinson Cvn 70, Unit 100111, Oral Surgery Department, Fpo, AP 96629 | 2014-06-10 |
| 1326397597 | Ricardo Vann Jr. | Military Health Care Provider | Hm2 Vann, Ricardo, Med, Fpo, AP 96629 | 2012-09-04 |
| 1043810716 | Odelia Nicole Mcfadden | Psychologist | Uss Carl Vinson, Unit 100111, Fpo, AP 96629 | 2020-10-30 |
| 1164999280 | Debra Hoffmann Houst | Psychologist | Medical Department, Uss Carl Vinson Cvn 70, Fpo, AP 96629-2840 | 2018-10-26 |
| 1316331564 | Joshua Daniel Whicker | Military Health Care Provider | Uss Carl Vinson, Fpo, AP 96629-2840 | 2015-03-26 |
| 1225389075 | Garry Poblete Closas | Nurse Practitioner | Uss Carl Vinson, Medical Department, Fpo, AP 96629-2840 | 2012-09-19 |
| 1841559846 | David Allen Moore | Family Medicine | Uss Carl Vinson, Cvn 70, Fpo, AP 96629-2840 | 2012-05-10 |
| 1679844229 | Nathan William Burger | Military Health Care Provider | Uss Carl Vinson, Cvn 70, Fpo, AP 96629-2840 | 2012-01-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841899853 | London Mingo | Social Worker | 2769 Yaka Kin Cho, Fpo, AP 96388-0071 | 2020-10-21 |
| 1538768833 | James Blake Weldon | Military Health Care Provider | Unit 100517 Bx 1, Fpo, AP 09655 | 2020-10-19 |
| 1487260311 | Doria Living | Registered Nurse | Ushno, Fpo, AP 96367 | 2020-09-16 |
| 1225643307 | Brice Blahnik | Dentist | 1 St Dental Battalion/naval Dental Center Attn: Medical, Bldg 2238 A Ave Camp Pendleton, Ca. 92055-5221, Fpo, AA 92055-5221 | 2020-09-15 |
| 1609489061 | Genesis Health Care Inc | Home Health | Uss Wasp Lhd1 Unit 100261, Fpo, AE 09514 | 2020-08-26 |
| 1669081857 | Acacia L Elmer | Registered Nurse | Psc 808 Box 3104, Fpo, AE 09618-0032 | 2020-07-24 |
| 1932724754 | William Dowling | Student in an Organized Health Care Education/Training Program | 260 John Paul Jones Circle, Fpo, AA 23708 | 2020-06-09 |
| 1518581776 | Taylor D Benson | Audiologist | Building 960, Floor 3, East Wing, Fpo, AP 96362-0017 | 2020-06-03 |
| 1740803279 | Issa Khalil | Military Health Care Provider | Uss Donald Cook, Fpo, AE 09566 | 2020-05-19 |
| 1295360055 | Kiran Kumar Gurung | Dental Hygienist | Uss Bataan (lhd-5), Fpo, AE 09554-1657 | 2020-03-11 |
| Find all providers in FPO | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710266044 | Daniel John Fisher | Dentist | Medical Staff Services, Bldg H 2005 Knight Lane, Fpo, AA 32212 | 2011-08-04 |
| 1417001835 | Uss Dwight D Eisenhower Cvn 69 | Dentist | Uss Dwight Eisenhower, Dental, Fpo, AE 09532 | 2007-01-23 |
| 1447486170 | Christopher Eric Crecelius | Dentist | Uss Abraham Lincoln, (cvn72) Dental Division, Fpo, AP 96612-2872 | 2009-06-09 |
| 1801859905 | Darius A Richardson | Dentist | Box 9095, Fpo, AP 96538 | 2006-04-10 |
| 1144209412 | Daniel P. Clifford | Dentist | Naval Hospital Okinawa, Psc 482 Box 1600, Fpo, AP 96362 | 2006-01-13 |
| 1801875836 | James B. Mazock | Dentist | Psc 819, Box 18-133, Fpo, SPAIN AE | 2006-01-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548222730 | Ronald Edward Prenzel | Dentist | B Co, 121 Csh, Unit 15244, Box 947, Apo, AP 96205 | 2006-04-04 |
| 1750366738 | Jose Miguel Santiago-cummings | Dentist | 618th Dental Company (as), Unit #15652, Apo, AP 96205-5652 | 2005-12-13 |
| 1770808875 | Christopher John Fries | Dentist | 18th Medical Group, Unit 5142, Apo, AP 96368 | 2010-03-31 |
| 1629054473 | James Eli Vangilder Iv | Dentist | 18th Dental Squadron, Unit 5270, Apo, AP 96368-5270 | 2005-12-22 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.