NPIMap

Individual provider Active NPI

Robert Utsman, DDS

  • Orofacial Pain Dentistry
  • Charleston, SC
National Provider Identifier
1386838068
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orofacial Pain DentistryTaxonomy code 1223X2210X
License
56 Issued in SC
Practice address
29 Bee Street
Charleston, SC 29425-7210
Phone
(843) 792-3444
NPI assigned
Sep 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 136000126 IL
Orofacial Pain Dentistry 1223X2210X 56 SC Primary

Addresses

Primary practice location

29 Bee Street
Charleston, SC 29425-7210

Mailing address

173 Ashley Ave, BSB 124
MSC 507
Charleston, SC 29425
Phone (843) 792-3939

Other practice location 1

801 S Paulina St
MC 621
Chicago, IL 60612-7210
Phone (312) 355-1661

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231106002034 SC Practitioner - Orofacial PainPractitioner - Dentist 9436506979 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orofacial PainAlso: Dentist
Education
University of Minnesota School of Dentistry, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

171 Ashley Ave
Charleston, SC 29425-8908
Phone (843) 792-1414

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
136000126ILMDGeneral Practice Dentistry
56SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Associates of the Medical University of South Carol CurrentSince Sep 2, 2023 Accepting new patients
University Medical Associates of the Medical University of South Carol CurrentSince Sep 2, 2023 Accepting new patients
Board of Trustees of the University of Illinois General Practice Past Accepting new patients

Locations

29 Bee St
Charleston, SC 29425
Phone (843) 792-2101

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

173 Ashley Ave
#124
Charleston, SC 29425
Phone (843) 792-2103

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 and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1188950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1386838068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "173 ASHLEY AVE, BSB 124",
            "address_2": "MSC 507",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29425",
            "telephone_number": "843-792-3939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 BEE STREET",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294257210",
            "telephone_number": "843-792-3444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 S Paulina St",
            "address_2": "MC 621",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606127210",
            "country_code": "US",
            "telephone_number": "312-355-1661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UTSMAN",
        "first_name": "ROBERT",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-05",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "136000126",
            "primary": false
        },
        {
            "code": "1223X2210X",
            "taxonomy_group": "",
            "desc": "Dentist, Orofacial Pain",
            "state": "SC",
            "license": "56",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.