Provider Demographics
NPI:1992048383
Name:EVANS, JAMES CALVIN (DDS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:CALVIN
Last Name:EVANS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:JAMES
Other - Middle Name:C
Other - Last Name:EVANS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:9406 W LAKE MEAD BLVD
Mailing Address - Street 2:105
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89134-8331
Mailing Address - Country:US
Mailing Address - Phone:702-331-9966
Mailing Address - Fax:
Practice Address - Street 1:9406 W LAKE MEAD BLVD
Practice Address - Street 2:105
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89134-8331
Practice Address - Country:US
Practice Address - Phone:702-331-9966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-03
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0852122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist