Active NPI
Gwyn Gordon McGutchen
- General Practice Dentistry
- Loris, SC
National Provider Identifier
1356684161
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 1597
- Practice address
- 3681 Spivey St.
Loris, SC 29569 - Phone
- (843) 756-5747
- Fax
- (843) 756-5749
- NPI assigned
- Mar 29, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 1597 | SC | Primary |
Addresses
Primary practice location
3681 Spivey St.
Loris, SC 29569
Mailing address
P.O. Box 220
3681 Spivey Steet,
Loris, SC 29569
Phone (843) 756-5747
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1597 | SC | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Loris Family Dentistry, LLC | Past | Accepting new patients | |
| Dr Gwyn Gordon McCutchen Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dentist
- Loris, SC
- NPI 1801914122
-
- Dentist
- Loris, SC
- NPI 1104272996
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1364515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364515200000",
"number": "1356684161",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 220",
"address_2": "3681 SPIVEY STEET,",
"city": "LORIS",
"state": "SC",
"postal_code": "29569",
"telephone_number": "843-756-5747",
"fax_number": "843-756-5749"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3681 SPIVEY ST.",
"city": "LORIS",
"state": "SC",
"postal_code": "29569",
"telephone_number": "843-756-5747",
"fax_number": "843-756-5749"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCGUTCHEN",
"first_name": "GWYN",
"middle_name": "GORDON",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-03-29",
"last_updated": "2013-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "SC",
"license": "1597",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Loris, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.