Individual provider Active NPI

Stevic Bartolabac Abad, DDS

  • General Practice Dentistry
  • Maysville, NC
National Provider Identifier
1245219724
Registry record updated Jan 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9627 Issued in NC
Practice address
1002 Jenkins Ave
Maysville, NC 28555-4401
Phone
(910) 743-2521
Fax
(910) 743-2531
NPI assigned
Jan 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2024

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 9627 NC Primary

Addresses

Primary practice location

1002 Jenkins Ave
Maysville, NC 28555-4401

Mailing address

1002 Jenkins Ave
Maysville, NC 28555-4401
Phone (910) 743-2521

Other practice location 1

315 McHugh Blvd
2D Dental Batallion/Naval Dental Center
Camp Lejeune, NC 28547-2511
Phone (910) 451-2208 ext. 203

Other practice location 2

1400 Industrial Dr
Kinston, NC 28504-4500
Phone (252) 523-0544

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20160329000891 NC Order and Referring Only - DentistPractitioner - Dentist 1759688252

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lane and Associates XL DDS PA General Practice CurrentSince Jan 14, 2024 Accepting new patients
Nirjal Patel, DMD, P.a. PastSince Aug 30, 2020 Accepting new patients
Sue a. Minneman-Fowler, DDS, PLLC PastSince Jan 14, 2024 Accepting new patients

Locations

1002 Jenkins Ave
Maysville, NC 28555
Phone (910) 743-2521

Organizations & group practices 3

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": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1245219724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 JENKINS AVE",
            "city": "MAYSVILLE",
            "state": "NC",
            "postal_code": "285554401",
            "telephone_number": "910-743-2521",
            "fax_number": "910-743-2531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 JENKINS AVE",
            "city": "MAYSVILLE",
            "state": "NC",
            "postal_code": "285554401",
            "telephone_number": "910-743-2521",
            "fax_number": "910-743-2531"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 McHugh Blvd",
            "address_2": "2D Dental Batallion/Naval Dental Center",
            "address_purpose": "LOCATION",
            "city": "Camp Lejeune",
            "state": "NC",
            "postal_code": "285472511",
            "country_code": "US",
            "telephone_number": "910-451-2208 x203",
            "fax_number": "910-451-8036",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 Industrial Dr",
            "address_purpose": "LOCATION",
            "city": "Kinston",
            "state": "NC",
            "postal_code": "285044500",
            "country_code": "US",
            "telephone_number": "252-523-0544",
            "fax_number": "252-523-4947",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABAD",
        "first_name": "STEVIC",
        "middle_name": "BARTOLABAC",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-12",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "9627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maysville, NC

Sources for this page

Verify at the official NPI Registry.