Active NPI
Hima Varna Bezawada
- Dentist
- Rock Hill, SC
National Provider Identifier
1760268155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 10638
- Practice address
- 128 Herlong Ave S Ste 102
Rock Hill, SC 29732-1156 - Phone
- (405) 410-5248
- NPI assigned
- Sep 1, 2023
- Last updated
- Sep 20, 2023
- Sex
- Female
- 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 | 10638 | SC | Primary |
Addresses
Primary practice location
128 Herlong Ave S Ste 102
Rock Hill, SC 29732-1156
Mailing address
123 NE 2ND St Apt 205
Oklahoma City, OK 73104-2256
Phone (405) 410-5248
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 |
|---|---|---|---|
| 10638 | SC | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1693526400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695168000000",
"number": "1760268155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "123 NE 2ND ST APT 205",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731042256",
"telephone_number": "405-410-5248"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "128 HERLONG AVE S STE 102",
"city": "ROCK HILL",
"state": "SC",
"postal_code": "297321156",
"telephone_number": "405-410-5248"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEZAWADA",
"first_name": "HIMA VARNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-09-01",
"last_updated": "2023-09-20",
"certification_date": "2023-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "SC",
"license": "10638",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rock Hill, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.