Provider Demographics
NPI:1427266345
Name:EVERTS, JOSHUA EDWARD (DDS, MD)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:EDWARD
Last Name:EVERTS
Suffix:
Gender:M
Credentials:DDS, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 1ST ST N
Mailing Address - Street 2:
Mailing Address - City:ALABASTER
Mailing Address - State:AL
Mailing Address - Zip Code:35007-8707
Mailing Address - Country:US
Mailing Address - Phone:205-208-0167
Mailing Address - Fax:
Practice Address - Street 1:420 1ST ST N
Practice Address - Street 2:
Practice Address - City:ALABASTER
Practice Address - State:AL
Practice Address - Zip Code:35007-8707
Practice Address - Country:US
Practice Address - Phone:205-208-0167
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2015-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL55831223S0112X
AL306191223S0112X, 204E00000X
GA0675601223S0112X
GA67562204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery