ANDREW EVANS (DMD) – Oral and Maxillofacial Surgery (Dentist), NPI 1588194328

ANDREW EVANS (DMD) is a healthcare provider. based in Champaign, Illinois. specializing in ORAL SURGERY, MAXILLOFACIAL SURGERY. They hold the professional credentials DMD. They hold a License No. 018.002025 (IL). The NPI Number for ANDREW EVANS (DMD) is 1588194328

Main info

Male
9 Years Of Experience
Accepts Medicare Assignment
Name
ANDREW EVANS (DMD)
NPI
1588194328
Phone
(217) 620-7705
Address
2418 FIELDS SOUTH DR APT 104
Enumeration Date
14 June 2017
Last Update Date
8 September 2022

Doctor Profile

Medical School Name
SOUTHERN ILLINOIS UNIV SCHOOL OF DENTAL MEDICINE
Secondary Phone
9038681370
Graduation Year
2017 (9 years ago)
PAC ID
4486926144
Group Practice PAC ID
9537180815
Professional Enrollment ID
I20230605002132
Address ID
TX750923424SH2903XFMXX301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:8State licenses:2Digital endpointsOther names

56 ORAL SURGERY in IL

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Provider Addresses for ANDREW EVANS (DMD)

  • 2418 FIELDS SOUTH DR APT 104

    CHAMPAIGN, IL 618223400

    Phone: (217) 620-7705

    Type: Mailing

  • Carle Foundation Hospital, 611, West Park Street, Urbana, Champaign County, Illinois, 61801, United States

    URBANA, IL 618012529

    Phone: (217) 620-7705

    Type: Location

  • 2903 N FM 1417

    SHERMAN, TX 750923424

    Phone: (217) 620-7705

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $38.

Total Amount is formed as General ($38) + Research ($0) + Ownership ($0) = $38.

Last reported payment date: 2024-05-21 • Largest payer in this snapshot: Dentsply Sirona Inc ($38).

Total Amount

$38

General + Research + Ownership

Payments

2

Total payment records

General Amount

$38

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-05-21

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Dentsply Sirona Inc$38
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-06-05

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230605002132IOral SurgeryTXTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 61822)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9537180815View full group profile
NameSpecialtyState
Oral Surgery, Maxillofacial SurgeryTX
-AR
Oral Surgery, Maxillofacial SurgeryTX
Maxillofacial Surgery, Oral SurgeryTX

Reviews

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Frequently asked questions

Is ANDREW EVANS (DMD) listed with a National Provider Identifier?
Yes — ANDREW EVANS (DMD) has NPI 1588194328 on file in the registry.
Active or inactive — what applies to ANDREW EVANS (DMD)?
You should see ANDREW EVANS (DMD) as active in CMS-hosted NPPES data.
What kind of doctor is ANDREW EVANS (DMD)?
ANDREW EVANS (DMD) is associated with Oral and Maxillofacial Surgery (Dentist) in the directory — Clinical services aligned with this taxonomy classification.
Is ANDREW EVANS (DMD) associated with Champaign?
Public fields place ANDREW EVANS (DMD) around Champaign, Illinois. Always confirm the exact site before visiting.
What does 4 location(s) imply?
4 practice locations appear in the available data.

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