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EVERGREEN ORAL SURGERY
NPI 1811586761
Oral & Maxillofacial Surgery in Tacoma, WA

Active since January 14, 2021
6050 TACOMA MALL BLVD STE 330, TACOMA, WA 98409(253) 473-0651(253) 444-0761 Get Directions Write a Review

NPPES record last updated: January 14, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Evergreen Oral Surgery NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EVERGREEN ORAL SURGERY (NPI 1811586761) is a healthcare organization registered as an oral & maxillofacial surgery in Tacoma, Washington and active in the NPI registry since January 2021. The organization maintains a secondary practice location in Puyallup and lists Angie Minks, Credentialing Specialist, as its authorized official.

NPPES Registry Identity

NPI1811586761
Entity TypeOrganization
Primary Taxonomy204E00000X
Legal Business NameEVERGREEN ORAL SURGERY
Location Address6050 TACOMA MALL BLVD STE 330Tacoma, WA 98409-6811
Mailing Address13894 Sunladen CtPickerington, OH 43147-8216 · (740) 243-6241 · Fax (740) 919-5871
Phone(253) 473-0651
Fax(253) 444-0761
Organization SubpartNo
Authorized OfficialAngie MinksCredentialing Specialist · (740) 243-6241
Enumeration DateJanuary 14, 2021
NPPES CertifiedJanuary 14, 2021
✔ NPI 1811586761 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOral & Maxillofacial SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code204E00000X
Definition
Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery.
6050 TACOMA MALL BLVD STE 330, Tacoma, WA 98409
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Secondary Practice Location 1

Location 110016 156th St EPuyallup, WA 98375-5103 · Phone (253) 799-1525 · Fax (253) 799-1524

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Evergreen Oral Surgery's NPI number?

The NPI number for Evergreen Oral Surgery is 1811586761. It was assigned to this organization in the NPPES registry on January 14, 2021.

Where is Evergreen Oral Surgery located?

Evergreen Oral Surgery is located at 6050 Tacoma Mall Blvd Ste 330, Tacoma, WA 98409. The listed phone number is (253) 473-0651.

What is Evergreen Oral Surgery's specialty?

The primary specialty registered for this NPI is Oral & Maxillofacial Surgery with taxonomy code 204E00000X.

When was this NPI record last updated?

The NPPES record for Evergreen Oral Surgery was last updated on January 14, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.