DR. AUSTIN EVANS (NPI# 1780931279) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780931279 |
| Entity Type | Individual |
| Full Name | DR. AUSTIN EVANS |
| Credential | D.M.D. |
| Practice Address |
340 Boatner Road Eglin Afb FL 32542 |
| Mailing Address |
1501 San Pedro Dr Se Bldg 48 377th Dental Squadron Albuquerque NM 87108-5153 |
| Practice Telephone | 8508838050 |
| Mailing Telephone | 5058463065 |
| Enumeration Date | 2012-08-14 |
| Last Update Date | 2013-08-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
9179 | KY | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972145779 | Austin Nicole Evans | Occupational Therapist | 2221 W Detroit St, Broken Arrow, OK 74012-3628 | 2019-10-13 |
| 1235795394 | Austin Grant Evans | Registered Nurse | 6161 S Yale Ave, Tulsa, OK 74136-1902 | 2019-05-14 |
| 1417418435 | Austin Lowry Evans | Student in an Organized Health Care Education/Training Program | 101 Manning Dr, Chapel Hill, NC 27514-4220 | 2019-03-31 |
| 1053843953 | Austin Joseph Evans | Student in an Organized Health Care Education/Training Program | 653-1 W 8th St, Jacksonville, FL 32209-6511 | 2017-03-30 |
| 1033596556 | Austin Godfrey Evans | Internal Medicine | 9449 Imperial Hwy, Downey, CA 90242-2814 | 2015-05-05 |
| Street Address |
340 BOATNER ROAD |
| City | EGLIN AFB |
| State | FL |
| Zip Code | 32542 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346523974 | Mary Elizabeth Sorrentino | Dentist | 340 Boatner Road, Blgd. 2751, Eglin Afb, FL 32542 | 2011-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417440306 | Colt Sicher | Student in an Organized Health Care Education/Training Program | 96th Dental Squadron (afmc), Eglin Afb, Fl 32542, Apo, AA 32542 | 2018-06-14 |
| 1841679529 | Matthew Scurria | Dentist | 340 Boatner Rd. Bldg 2751, 96 Dental Squadron/sgdr, Eglin Afb, FL 32542 | 2015-05-27 |
| 1134518798 | 96th Medical Support Squadron | Military/U.S. Coast Guard Pharmacy | 3120 A. Talon Way, Eglin Afb Fld #3, FL 32542 | 2015-01-20 |
| 1598177123 | 96th Medical Support Squadron | Military/U.S. Coast Guard Pharmacy | 96 Medical Group Satellite Phcy Memorial Trail, Bldg. 1758, Eglin Afb, FL 32542 | 2014-06-02 |
| 1548602923 | Gerald Jordan Novack | Psychologist | 96mdos/sgow, 307 Boatner Rd, Fpo, AP 32542 | 2013-07-25 |
| 1699112821 | Taylor Anne Hahn | Obstetrics & Gynecology | 96th Medical Group, 307 Boatner Road, Eglin Air Force Base, FL 32542 | 2013-05-29 |
| 1730456948 | Nicholas Brandon Sager | Dentist | 340 Boatner Rd, Eglin Afb, Apo, AA 32542 | 2011-11-17 |
| 1134402662 | Jessamy Jae Thornton | Student in an Organized Health Care Education/Training Program | 340 Boatner Rd, Bldg 2751, Eglin Afb, FL 32542 | 2011-09-21 |
| 1588945612 | Martin Army Community Hospital | Clinic/Center | 4327 North El Salvador Way, Eglin Afb, FL 32542 | 2011-09-02 |
| 1144516287 | Russell David Bienias | Dentist | 96th Dental Squadron (afmc), Eglin Afb, FL 32542 | 2011-06-28 |
| Find all providers in zip 32542 | ||||
| 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 |
|---|---|---|---|---|
| 1114583580 | Connor Madison Luttrell | Dentist | 350 Boatner Rd, Eglin Afb, FL 32542-1391 | 2019-05-11 |
| 1346760113 | Nikkisha Mercado | Dentist | 340 Boatner Rd. Bldg 2751, 96 Dental Squadron/sgdr, Eglin Afb, FL 32542 | 2017-06-22 |
| 1346687373 | Lisa Darbonne Rackley | Dentist | 96th Medical Group, 307 Boatner Road, Eglin Afb, FL 32542 | 2013-05-31 |
| 1225304041 | Ross K Oates | Dentist | 307 Boatner Rd Ste 114, Eglin Afb, FL 32542-1302 | 2012-03-26 |
| 1568558286 | Ashley Brooks | Dentist | 307 Boatner Road, Eglin Afb, FL 32542 | 2006-10-04 |
| 1699870311 | Adam Andrew Kuipers | Dentist | 307 Boatner Rd Ste 114, Eglin Afb, FL 32542-1302 | 2006-09-14 |
| 1467477174 | Robert Michael Garrett | Dentist | 307 Boatner Rd, Suite 114, Eglin Afb, FL 32542-1391 | 2006-07-13 |
| 1982669768 | Lance R Washburn | Dentist | 307 Boatner Rd Ste 114, Eglin Afb, FL 32542-1302 | 2006-04-17 |
| 1245294743 | Douglas John Ammon | Dentist | 307 Boatner Rd Ste 114, Eglin Afb, FL 32542-1302 | 2006-04-13 |
| 1588652655 | Rommie Glen Wheeler Sr. | Dentist | 307 Boatner Rd, Eglin Afb, FL 32542-1391 | 2005-10-12 |
| Find all providers in EGLIN AFB | ||||
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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.