DR. EVAN MICHAEL BLACK (NPI# 1316599020) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316599020 |
| Entity Type | Individual |
| Full Name | DR. EVAN MICHAEL BLACK |
| Credential | D.M.D. |
| Practice Address |
200 Mercy Cir Building H-200 4th Floor Fpo AA 92055 |
| Practice Telephone | 7607194747 |
| Mailing Telephone | 7607194747 |
| Enumeration Date | 2019-07-12 |
| Last Update Date | 2019-07-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
DS042340 | PA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932185089 | Evan H Black | Ophthalmology | 4717 St. Antoine, Kresge Eye Institute, Detroit, MI 48201-1423 | 2005-12-21 |
| 1346260247 | Evan G Black | Psychiatry & Neurology | 5323 Woodrow St, #201, Murray, UT 84107-5841 | 2006-07-20 |
| Street Address |
200 MERCY CIR BUILDING H-200 4TH FLOOR |
| City | FPO |
| State | AA |
| Zip Code | 92055 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235730755 | Zaccary Griffin | Military Health Care Provider | Building 4101 Stuart Mesa Rd, Camp Pendleton, CA 92055 | 2020-11-02 |
| 1194325597 | Connie Lim Good | Dental Hygienist | 14th Street Bldg 13128, Oceanside, CA 92055 | 2020-10-27 |
| 1386243327 | Leticia Isabel Alcantar | Dental Hygienist | Bldg 520448, Camp Pendleton, CA 92055 | 2020-10-21 |
| 1548869571 | Joshua Watersjackson | Specialist/Technologist | 430406 Las Pulgas, Camp Pendleton, CA 92055 | 2020-10-21 |
| 1235737164 | Tynesha Felice Calimquim | Dental Hygienist | Naval Hospital Camp Pendleton, Dental Department, 200 Mercy Circle, Oceanside, CA 92055 | 2020-10-13 |
| 1801494182 | Luis Alberto Necoechea | Military Health Care Provider | 1st Recon Bn Bas, Oceanside, CA 92055 | 2020-10-09 |
| 1689271603 | Lorena Santodomingo | Dental Hygienist | Bldg 210735 C Street, Camp Pendleton, CA 92055 | 2020-10-02 |
| 1720695984 | Douglas Thomas Duncan | Dental Assistant | 92055- 14th Strret, Oceanside, CA 92055 | 2020-09-30 |
| 1528675980 | Dora Louise Young | Dental Assistant | 92055 14th Street, Camp Pendleton, CA 92055 | 2020-09-29 |
| 1306453956 | Lynne Marie Reardon | Dental Hygienist | Bldg 310515, Camp Pendleton, CA 92055 | 2020-09-28 |
| Find all providers in zip 92055 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639723208 | James Jordan Kline | Dentist | Parris Island, Dental Clinic, Fpo, AA 29905 | 2019-07-31 |
| 1902459928 | Gabrielle Klatt | Dentist | Naval Hospital Camp Pendleton Dental Department, Fpo, AA 92055 | 2019-07-18 |
| 1417509530 | Andrew Grant Miner | Dentist | Naval Hospital Beaufort, 1 Pinckney Blvd., Fpo, AA 29902 | 2019-07-09 |
| 1346655644 | Andrew Woodward Hubbard | Dentist | Uss Bataan, Lhd-5, Fpo, AE 09554-1657 | 2014-06-25 |
| 1740615350 | John Houston Greiner | Dentist | 13 Adc Mainside, 92055, Fpo, AA 92055-5221 | 2013-09-13 |
| 1790127835 | Tyson Andrew Ellenbecker | Dentist | 1st Dental Bn/ndc Camp Pendleton, Box 555221, Fpo, AA 92054-2055 | 2013-07-17 |
| 1912345448 | Austin Joseph Ladner | Dentist | 99th Air Base Wing Public Affairs, Fpo, AA 89191 | 2013-06-06 |
| 1396093589 | Samir Misdaq Hussain | Dentist | Psc 475 Box 1515, Fpo, AP 96350-1515 | 2012-08-21 |
| 1164770517 | James Stephen Feliz | Dentist | Psc 477 Box#2, Fpo, AP 96306 | 2012-08-16 |
| 1902032907 | Joseph R Platt | Dentist | Psc 557 Box 1753, Fpo, AP 96379-1700 | 2009-06-04 |
| Find all providers in FPO | ||||
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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.