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General NPI Number Information
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NPI Number | 1770288060
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Entity Type | Individual
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Provider Name | DIANE EVANS DDS
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Gender | Female
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Dates
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Enumeration Date | 04/04/2023
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Last Update Date | 07/12/2025
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Provider Practice Location Address
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Address Line | 1505 W BUCKINGHAM RD
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City | GARLAND
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State | TX
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Zip | 75042-4204
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Country | US
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Telephone | 469-649-1017
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Fax |
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Provider Business Mailing Address
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Address Line | 4914 LIVE OAK ST UNIT 5
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City | DALLAS
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State | TX
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Zip | 75206-8872
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Country | US
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Telephone | 214-592-5892
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 41507
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License Number State | TX
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