Active NPI
Gregg Steven Svoma
- Dentist
- Avon, IN
National Provider Identifier
1497971915
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 12009587
- Practice address
- 7130 E Co Rd 150 South
Avon, IN 46123-8190 - Phone
- (317) 837-8900
- Fax
- (317) 837-8908
- NPI assigned
- Apr 17, 2007
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 12009587 | IN | Primary |
Addresses
Primary practice location
7130 E Co Rd 150 South
Avon, IN 46123-8190
Mailing address
7130 E Co Rd 150 South
Avon, IN 46123-8190
Phone (317) 837-8900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 861062947 | Other | IN | TAX ID # |
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 |
|---|---|---|---|
| 12009587 | IN | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1497971915",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7130 E CO RD 150 SOUTH",
"city": "AVON",
"state": "IN",
"postal_code": "461238190",
"telephone_number": "317-837-8900",
"fax_number": "317-837-8908"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7130 E CO RD 150 SOUTH",
"city": "AVON",
"state": "IN",
"postal_code": "461238190",
"telephone_number": "317-837-8900",
"fax_number": "317-837-8908"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SVOMA",
"first_name": "GREGG",
"middle_name": "STEVEN",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IN",
"license": "12009587",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID #",
"identifier": "861062947",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Avon, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.