# DR JAIME V. EVANGELISTA JR., DMD

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- **Entity:** Organization
- **Status:** Active
- **Other names:** gateway plaza dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215396809
- **Authorized official:** DR. JAIME V EVANGELISTA JR. DMD (DENTIST)
- **Authorized official phone:** (510) 887-6835

## Contact information

- **Practice address:** 24901 SANTA CLARA ST \# B2, HAYWARD, CA 94544-2147
- **Practice address phone:** (510) 887-6835
- **Practice address fax:** (510) 887-2872
- **Mailing address:** 24901 SANTA CLARA ST \# B2, HAYWARD, CA 94544-2147
- **Mailing address phone:** (510) 887-6835
- **Mailing address fax:** (510) 887-2872

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 37103 | CA | Yes |

## Other

- **Enumeration date:** 02/11/2016
- **Last updated:** 02/11/2016