Kelvin Bostick, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DGD.8660 GD Issued in SC

Practice address

10832 N Jacob Smart Blvd
Ridgeland, SC 29936-2707

Phone

(843) 726-5711

NPI assigned

Oct 26, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Earl Bostick,Sr. D.M.D & Assoc. P.a.

  • General Practice Dentistry
  • Beaufort, SC
  • NPI 1114109618
  NPD (past)
• Earl Bostick,Sr. D.M.D.

  • General Practice Dentistry
  • Ridgeland, SC
  • NPI 1316157704
  NPD (past)

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

{
    "created_epoch": "1445817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445817600000",
    "number": "1477925824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2260",
            "city": "RIDGELAND",
            "state": "SC",
            "postal_code": "299362638",
            "telephone_number": "843-726-5711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10832 N JACOB SMART BLVD",
            "city": "RIDGELAND",
            "state": "SC",
            "postal_code": "299362707",
            "telephone_number": "843-726-5711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSTICK",
        "first_name": "KELVIN",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-26",
        "last_updated": "2015-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "DGD.8660 GD",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1457372948",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bluffton Okatie Counseling Center, LLC
• Angela Fay Bolden
• Ashley L Bolden
• Bollin Optometry LLC
• Earl Bostick Sr., DMD
• Courtney Anne Bostjancic, D.C.
• Michael John Bostjancic, D.C.
• Joann Lynn Brazil, APRN
• Bright Light Behavioral and Developmental Services
• Brighter Day at Home LLC

• General Practice Dentistry in Ridgeland, SC
• Providers in Ridgeland, SC by specialty
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2015; 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.