Provider Demographics
NPI:1215675418
Name:EVANS, SHELDONIA KHRYSTEL (DDS)
Entity type:Individual
Prefix:DR
First Name:SHELDONIA
Middle Name:KHRYSTEL
Last Name:EVANS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4259 ROBERT C BYRD DR
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-2223
Mailing Address - Country:US
Mailing Address - Phone:304-207-0999
Mailing Address - Fax:
Practice Address - Street 1:4259 ROBERT C BYRD DR
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-2223
Practice Address - Country:US
Practice Address - Phone:304-207-0999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-26
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV4585122300000X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist