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1417279134 NPI number — ANA ELASHVILI EVANS D.D.S., M.S.

NPI Number: 1417279134
Health Care Provider/Practitioner: ANA ELASHVILI EVANS D.D.S., M.S.

Information about “1417279134” NPI (ANA ELASHVILI EVANS D.D.S., M.S.) exists in 1417279134 in HTML format HTML  |  1417279134 in plain Text format TXT  |  1417279134 in PDF (Portable Document Format) PDF  |  1417279134 in an XML format XML  formats.

NPI Number : 1417279134 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1417279134",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "EVANS",
    "FirstName": "ANA",
    "MiddleName": "ELASHVILI",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "D.D.S., M.S.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "624 S GILPIN ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "DENVER",
    "MailingAddressStateName": "CO",
    "MailingAddressPostalCode": "80209-4512",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "720-255-7047",
    "MailingAddressFaxNumber": "303-724-7079",
    "FirstLinePracticeLocationAddress": "13065 E 17TH AVE",
    "SecondLinePracticeLocationAddress": "MAIL STOP F 742",
    "PracticeLocationAddressCityName": "AURORA",
    "PracticeLocationAddressStateName": "CO",
    "PracticeLocationAddressPostalCode": "80045-2532",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "303-724-5505",
    "PracticeLocationAddressFaxNumber": "303-724-5456",
    "EnumerationDate": "02/22/2010",
    "LastUpdateDate": "12/18/2020",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "122300000X",
        "TaxonomyName": "Dentist",
        "LicenseNumber": "501",
        "LicenseNumberStateCode": "CO",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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