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General NPI Number Information
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NPI Number | 1174447130
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Entity Type | Organization
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Legal Business Name | EVO ENDODONTICS, PLLC
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Dates
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Enumeration Date | 08/04/2026
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Last Update Date | 08/04/2026
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Provider Practice Location Address
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Address Line | 2120 PRAIRIE DR STE 1001
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City | PROSPER
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State | TX
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Zip | 75078-4152
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Country | US
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Telephone | 469-897-5545
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Fax |
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Provider Business Mailing Address
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Address Line | 5750 COTTON GIN RD APT 2166
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City | FRISCO
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State | TX
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Zip | 75034-0449
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Country | US
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Telephone | 215-350-3330
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Fax |
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Authorized Official
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Title or Position | ENDODONTIST
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Name | EUNJUNG JI
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Credential | DMD
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Telephone | 215-350-3330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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