Healthcare Provider Details

I. General information

NPI: 1043394828
Provider Name (Legal Business Name): THE KIDDS PLACE, DENTISTRY FOR CHILDREN, P.S.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 E HASTINGS RD SUITE B
SPOKANE WA
99218-1900
US

IV. Provider business mailing address

506 E HASTINGS RD SUITE B
SPOKANE WA
99218-1900
US

V. Phone/Fax

Practice location:
  • Phone: 509-252-4746
  • Fax: 509-789-1640
Mailing address:
  • Phone: 509-252-4746
  • Fax: 509-789-1640

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDE00010191
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDE00006525
License Number StateWA

VIII. Authorized Official

Name: DR. JARED D. EVANS
Title or Position: PRESIDENT
Credential: D.M.D.
Phone: 509-252-4746