Active NPI
Spencer Curtis Bevan
- Dentist
- Columbia, SC
National Provider Identifier
1669996591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 10380211-9922
- Practice address
- 4323 Hill St
Columbia, SC 29207-6022 - Phone
- (803) 751-4512
- NPI assigned
- Aug 2, 2017
- 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 | 10380211-9922 | UT | Primary |
Addresses
Primary practice location
4323 Hill St
Columbia, SC 29207-6022
Mailing address
4115 S Colt Haven Cir
Salt Lake City, UT 84124-2655
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 |
|---|---|---|---|
| 10380211-9922 | UT | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1501632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1501632000000",
"number": "1669996591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4115 S COLT HAVEN CIR",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841242655"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4323 HILL ST",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292076022",
"telephone_number": "803-751-4512"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEVAN",
"first_name": "SPENCER",
"middle_name": "CURTIS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-08-02",
"last_updated": "2017-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "UT",
"license": "10380211-9922",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.