MEDICARE: DR. STEVEN ELLIOT EVENS DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	5284	VA

General Provider Information

NPI Number	:	1588851729
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN ELLIOT EVENS DDS

Provider Business Mailing Address
First Line	:	5311 PATTERSON AVE
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23226-2041
Country	:	US
Telephone Number	:	804-282-6665
Fax Number	:	804-288-5878

Provider Business Practice Location Address
First Line	:	5311 PATTERSON AVE
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23226-2041
Country	:	US
Telephone Number	:	804-282-6665
Fax Number	:	804-288-5878

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2007
Last Update Date	:	10/02/2007

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