Jaime V. Evangelista, Jr, dmd
Dentist in Hayward, CA. Individual provider (NPI-1).
NPI number1750839957
StatusActive
Last updated in NPPESSep 15, 2016
Details
- NPI
- 1750839957
- Entity type
- Individual (NPI-1)
- Name
- Jaime V. Evangelista, Jr
- Credential
- dmd
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Sep 15, 2016
- Last updated
- Sep 15, 2016
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 37103 | CA | Yes |
Practice location
24901 Santa Clara St # B2Hayward, CA 94544-2147
Phone 510-887-6835 · Fax 510-887-2872
Mailing address
24901 Santa Clara St # B2Hayward
Hayward, CA 94544-2147
Phone 510-887-6835 · Fax 510-887-2872
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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