Individual provider Active NPI

Lawrence P Evola, D.D.S

  • General Practice Dentistry
  • Summerville, SC
National Provider Identifier
1245440148
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9663 Issued in SC
Practice address
101 Harth PL
Summerville, SC 29485-8107
Phone
(843) 875-5111
NPI assigned
May 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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 9663 SC Primary

Addresses

Primary practice location

101 Harth PL
Summerville, SC 29485-8107

Mailing address

1533 Eastham LN Ste 4
Mt Pleasant, SC 29466-7563
Phone (171) 687-0648

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
9663SCMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1245440148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1533 EASTHAM LN STE 4",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294667563",
            "telephone_number": "171-687-0648",
            "fax_number": "716-656-8713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 HARTH PL",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294858107",
            "telephone_number": "843-875-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVOLA",
        "first_name": "LAWRENCE",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "9663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.