DR. KEITH ALLEN EVANS (NPI# 1215009923) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215009923 |
| Entity Type | Individual |
| Full Name | DR. KEITH ALLEN EVANS |
| Credential | D.M.D., M.S. |
| Practice Address |
113 N Regency Dr Bloomington IL 61701-3515 |
| Practice Telephone | 3096618900 |
| Practice Fax Number | 3096618118 |
| Mailing Telephone | 3096618900 |
| Mailing Fax Number | 3096618118 |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2014-03-12 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 7391 | NC | Dental Providers |
| N | 122300000X | Dentist | 19-025805 | IL | Dental Providers |
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
021-002108 | IL | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750828406 | Keith B Evans | Clinical Nurse Specialist | 12 Lincoln Dr, Shelby, OH 44875-1482 | 2017-01-19 |
| 1942549746 | Keith Evans | Student in an Organized Health Care Education/Training Program | 56 Chestnut Ln, Pine Grove, PA 17963-8741 | 2013-02-14 |
| 1518080977 | Keith E. Evans | Physical Therapist | 3250 Hogan Rd, Sw, Atlanta, GA 30331-2830 | 2007-04-09 |
| 1033179049 | Keith H Evans | General Practice | 1140 W 500 S, Vernal, UT 84078-2914 | 2006-03-24 |
| 1992704688 | Keith Alan Evans | Chiropractor | 4220 Treadway Rd, Beaumont, TX 77706-7105 | 2005-07-15 |
| 1508116971 | Keith L Evans Jr. | Counselor | 62 Village Ln, Berwick, PA 18603-5741 | 2012-09-13 |
| 1982804084 | Keith Evans | Physical Therapy Assistant | 4001 Capitol Mall Dr Sw, Olympia, WA 98502-8657 | 2007-07-18 |
| Street Address |
113 N REGENCY DR |
| City | BLOOMINGTON |
| State | IL |
| Zip Code | 61701-3515 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396164398 | Endodontists of Illinois | Dentist | 113 N Regency Dr, Bloomington, IL 61701-3515 | 2014-04-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770140964 | County of Mclean | Community/Behavioral Health | 200 W Front St, 1st Floor Sw, C/o 200 W Front St, Suite 400f, Bloomington, IL 61701 | 2019-05-22 |
| 1023525292 | Karli Johnson | Counselor | 200 W Monroe St Ste C7, Bloomington, IL 61701 | 2018-01-09 |
| 1487172409 | Melody Ann Bauman | Physician Assistant | 1505 Eastland Dr, Osf Critical Cane, Pulmonary, Sleep M, Bloomington, IL 61701 | 2017-08-30 |
| 1215396288 | Heidi Larsen | Social Worker | 902 S East St, Bloomington, IL 61701 | 2016-02-18 |
| 1558735126 | Andrea E. Andrews Counseling LLC | Counselor | 200 W. Monroe St., Ste 302 C, Bloomington, IL 61701 | 2015-11-19 |
| 1174924856 | Carole Hahn | Dietitian, Registered | 1406 Forrest St, Bloomington, IL 61701 | 2014-09-12 |
| 1558786392 | Valerie Colleen Parker | Counselor | 109 W. Mulberry St., Bloomington, IL 61701 | 2014-03-04 |
| 1124459219 | Matilde Francois | Surgery | 1505 Eastland Dr Ste 2300, Bloomington, IL 61701 | 2013-11-27 |
| 1922435114 | Smitha H Shivaprasad | Pharmacist | 2611 East Oakland Avenue, Bloomington, IL 61701 | 2013-10-02 |
| 1295161941 | Ashvin Patel | Obstetrics & Gynecology | 31 Country Club Pl, Bloomington, IL 61701 | 2013-09-25 |
| Find all providers in zip 61701 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518488055 | Seth Thomas Barnett | Dentist | 3601 General Electric Rd Ste 6, Bloomington, IL 61704-8566 | 2017-07-06 |
| 1245415348 | Evans Endodontics, P.C. | Dentist | 208 N Williamsburg Dr, Bloomington, IL 61704-3571 | 2008-01-08 |
| 1568664886 | Steven Mark Sieraski | Dentist | 3601 General Electric Rd, Suite 6, Bloomington, IL 61704-8533 | 2007-05-31 |
| 1194895219 | Endodontic Specialists LLC | Dentist | 3601 General Electric Road, Suite 6, Bloomington, IL 61704 | 2006-11-08 |
| 1043219199 | Allen Wesley Meier | Dentist | 3901 Hagan St, Suite B, Bloomington, IN 47401-8557 | 2005-07-20 |
| 1396164398 | Endodontists of Illinois | Dentist | 113 N Regency Dr, Bloomington, IL 61701-3515 | 2014-04-08 |
| 1427271410 | Joseph Spires | Dentist | 641 S Walker St, Suite C, Bloomington, IN 47403-2154 | 2007-04-10 |
| 1487719209 | Jeffrey D. Erickson | Dentist | 8900 Penn Ave S, 105, Bloomington, MN 55431-2068 | 2006-12-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669089777 | Sebastian Przybylo, Dmd, Pllc | Dentist | 350 S Northwest Hwy Ste 116, Park Ridge, IL 60068-4262 | 2020-09-24 |
| 1770126740 | Old Orchard Endodontics | Dentist | 4905 Old Orchard Ctr Ste 216, Skokie, IL 60077-4741 | 2019-10-23 |
| 1194380741 | Vasiliki Kytridou | Dentist | 2800 College Avenue Southern Il University School of De, Building 285, Alton, IL 62002 | 2019-05-08 |
| 1134782592 | Endodontics of Springfield | Dentist | 997 Clock Tower Dr Ste C, Springfield, IL 62704-1399 | 2019-04-20 |
| 1942793815 | Millennium Dental Specialist | Dentist | 1624 W Division St Ste B, Chicago, IL 60622-3908 | 2018-06-14 |
| 1588163364 | Advanced Endodontics, PC | Dentist | 103 S. Greenleaf Street, Suite K, Gurnee, IL 60031 | 2018-02-07 |
| 1023562857 | Jwwdental LLC | Dentist | 808 E Woodfield Rd, Suite 300, Schaumburg, IL 60173-4816 | 2016-08-10 |
| 1629453378 | Charles Richard Neach | Dentist | 801 S Paulina St Rm 302a, Chicago, IL 60612-7210 | 2015-07-23 |
| 1619360096 | Rajan Sharma | Dentist | 6319 Fairview Ave Ste 103, Westmont, IL 60559-2889 | 2015-03-10 |
| 1821491937 | West Suburban Endodontics LLC | Dentist | 1749 S Naperville Road, Suite 100, Wheaton, IL 60189 | 2014-10-02 |
| Find all providers with the same taxonomy | ||||
| City | BLOOMINGTON |
| Zip Code | 61701 |
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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.