Individual provider Active NPI

Robert A. Varn, DMD

  • General Practice Dentistry
  • Orangeburg, SC
National Provider Identifier
1053472563
Registry record updated Apr 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1836 Issued in SC
Practice address
695 Laurel St
Orangeburg, SC 29115-4834
Phone
(803) 536-6440
Fax
(803) 268-9921
NPI assigned
Dec 12, 2006
Last updated
Apr 9, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 1836 SC Primary

Addresses

Primary practice location

695 Laurel St
Orangeburg, SC 29115-4834

Mailing address

695 Laurel St
Orangeburg, SC 29115-4834
Phone (803) 536-6440

Other identifiers 1

IdentifierTypeStateIssuer
Z18366MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150506001241 SC Order and Referring Only - DentistPractitioner - Dentist 0244559607

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1836SCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orangeburg Family Dentistry,LLC General Practice Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428537600000",
    "number": "1053472563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "695 LAUREL ST",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291154834",
            "telephone_number": "803-536-6440",
            "fax_number": "803-268-9921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "695 LAUREL ST",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291154834",
            "telephone_number": "803-536-6440",
            "fax_number": "803-268-9921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARN",
        "first_name": "ROBERT",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2015-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "1836",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Z18366",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orangeburg, SC

Sources for this page

Verify at the official NPI Registry.