| Doctor Name: | DR. JONATHAN DAVID EVANS |
| NPI Number: | 1033106000 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DDS |
| License Number: | 19482 |
| Business Practice Address: | 52d Medical Group Unit 3865 Apo, AE - 091263865 |
| Business Phone Number: | 496565913590 |
| Business Fax Number: | |
| Mailing Address: | 52d Medical Group, Unit 3865 APO |
| State: | AE |
| Postal Code: | 091263865 |
| Phone Number: | 496565913590 |
| Fax Number: | |
| NPI Enumeration Date: | 10/04/2005 |
| NPI Last Update Date: | 09/07/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1223P0221X |
| License Number: | 19482 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Dental Providers |
| Taxonomy Classification: | Dentist |
| Taxonomy Specialization: | Pediatric Dentistry |
| Taxonomy Definition: | An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |