DR. KEITH ALLEN EVANS D.M.D. M.S. NPI 1215009923

NPI Information

NPI: 1215009923
Provider Name: DR. KEITH ALLEN EVANS, D.M.D., M.S.
Classification: Dentist - 1223E0200X
Entity Type: Individual

Specialization: Endodontics

Address:
113 N REGENCY DR
BLOOMINGTON, IL
ZIP 61701
Phone: (309) 661-8900
Get Directions

DR. Keith Allen Evans, D.M.D., M.S. is an endodontics dentist in Bloomington, IL. The provider is the branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. DR. Keith Allen Evans, D.M.D., M.S. NPI is 1215009923. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

113 N REGENCY DR
BLOOMINGTON, IL
ZIP 61701-515
Phone: (309) 661-8900
Fax: (309) 661-8118

The enumeration date for this NPI number is 11/15/2006 and was last updated on 3/12/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	122300000X	Dentist		19-025805	ILLINOIS	No
2	122300000X	Dentist		7391	NORTH CAROLINA	No
3	1223E0200X	Dentist	Endodontics	021-002108	ILLINOIS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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