EVOLUTION DENTAL ALLIANCE (NPI# 1689175309) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689175309 |
| Entity Type | Organization |
| Organization Name | EVOLUTION DENTAL ALLIANCE |
| Practice Address |
507 S Washington St Ste 190 Spokane WA 99204-2608 |
| Mailing Address |
507 S Washington St Ste 40 Spokane WA 99204-2604 |
| Practice Telephone | 5095660000 |
| Enumeration Date | 2018-02-27 |
| Last Update Date | 2018-02-27 |
| Authorized Official Name | DR. JOEL BLAKE (CHIEF CLINICAL OFFICER) |
| Authorized Official Telephone | 5098222209 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | EVOLUTION DENTAL ALLIANCE L.L.C. | 9067 W Post Road, Suite C, Las Vegas, NV 89148 |
| Street Address |
507 S WASHINGTON ST STE 190 |
| City | SPOKANE |
| State | WA |
| Zip Code | 99204-2608 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710538285 | Lemone and Plaster Pllc | Dentist | 507 S Washington St Ste 190, Spokane, WA 99204-2604 | 2019-09-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982250957 | Megan Elizabeth Dibenedetto | Pharmacist | 105 West 8th Avenue, 350e, Spokane, WA 99204 | 2019-08-14 |
| 1619521168 | Evelyn R Cabon | Genetic Counselor, MS | 101 W. 8th Avenue Suite 1100, Spokane, WA 99204 | 2019-08-01 |
| 1346700655 | Christina Rose | Student in an Organized Health Care Education/Training Program | 120 W. 8th Avenue, Spokane, WA 99204 | 2019-03-22 |
| 1508339862 | Cody J French | Physical Therapist | Washington Outpatient Rehab, 507 S Washington, Spokane, WA 99204 | 2019-01-09 |
| 1730655598 | Washington Outpatient Rehabilitation, LLC | Physical Therapist | 507 S. Washington St., Suite 10, Spokane, WA 99204 | 2018-10-19 |
| 1013405547 | Joel James Hayden | Student in an Organized Health Care Education/Training Program | Providence Sacred Heart, 101 West 8th Avenue, Spokane, WA 99204 | 2018-04-30 |
| 1144694787 | Brooksjohnsonpllc | Dentist | 1004 S. Monroe Street, Ste 100, Spokane, WA 99204 | 2015-11-19 |
| 1497184196 | Kathalene M Cassels | Physician Assistant | 810 W. 5th Ave. Ste 510, Spokane, WA 99204 | 2013-11-04 |
| 1174880454 | Kelly E Wurzel | Psychiatry & Neurology | 624 E. Front Ave, Spokane, WA 99204 | 2012-04-11 |
| 1003190331 | Katie L Gomez | Nurse Practitioner | 805 W. 5th Ave, Suite 518, Spokane, WA 99204 | 2011-10-05 |
| Find all providers in zip 99204 | ||||
| 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 |
|---|---|---|---|---|
| 1427662303 | Dr. Teemu J Scarborough Dds PC | Dentist | 707 W Francis Ave Ste 100, Spokane, WA 99205-6401 | 2020-09-08 |
| 1932682374 | Dental Professionals of Washington Quirt Mongrain Gibree PC | Dentist | 2807 S Stone St Ste 102, Spokane, WA 99223-4904 | 2018-09-12 |
| 1821582735 | Dental Professionals of Washington Quirt Mongrain Gibree PC | Dentist | 1520 W Garland Ave Ste A, Spokane, WA 99205-2613 | 2018-06-15 |
| 1528411600 | Richard G Witter, Dds | Dentist | 3150 E 27th Ave # 200, Spokane, WA 99223-4919 | 2016-07-13 |
| 1922461409 | Michael Davis Dmd Pllc | Dentist | 15 E Central Ave Ste 2, Spokane, WA 99208-1109 | 2016-04-01 |
| 1174938500 | Heather Marie Moore | Dentist | 101 W. Cascade Way Suite 202, Cascade Dental Care, Spokane, WA 99208-6016 | 2014-06-24 |
| 1235550898 | Penelope Walpole | Dentist | 9802 E. Holman Rd, Spokane, WA 99206 | 2013-12-30 |
| 1437590338 | Thomas A Stein | Dentist | 520 S Cowley St Ste 105, Spokane, WA 99202-1315 | 2013-07-09 |
| 1710242367 | Amy Clement | Dentist | 4815 N Assembly St., Spokane, WA 99205 | 2012-07-10 |
| 1700154200 | Jon Montgomery Wamba | Dentist | 1602 E Heritage Ln, Spokane, WA 99208-8509 | 2011-12-12 |
| Find all providers in SPOKANE | ||||
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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.