Evans, Jared Dean
Evans, Jared Dean is an sole proprietor health care provider with primary practice located at 1327 N Stanford Ln Suite B, Liberty Lake WA 99019-5034. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Evans, Jared Dean can be contacted via phone (509) 891-7070.Contact Information
Primary practice address
1327 N Stanford Ln Suite B
Liberty Lake WA 99019-5034
Phone: (509) 891-7070
Fax: (509) 891-4741
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Pediatric Dentistry | 1223P0221X | DE00010191 | Washington |
| Dental Providers / Pediatric Dentistry | 1223P0221X | DN16714 | Florida |
Profile Details
| NPI number | 1306927892 |
|---|---|
| LBN Legal business name | Evans, Jared Dean |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 18th, 2006 |
| Last updated | Jul 27th, 2012 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1306927892 | NPPES |
| Washington | MEDICAID | 5048236 | |
| Washington | MEDICAID | 5050513 |
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