Individual provider Active NPI

David Brian Tevepaugh, D.M.D

  • Oral and Maxillofacial Surgery (Dentist)
  • Columbia, SC
National Provider Identifier
1871570804
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
3085 Issued in SC
Practice address
1755 Saint Julian PL
Columbia, SC 29204-2409
Phone
(803) 254-2972
Fax
(803) 799-2151
NPI assigned
Dec 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 3085 SC Primary

Addresses

Primary practice location

1755 Saint Julian PL
Columbia, SC 29204-2409

Mailing address

1755 Saint Julian PL
Columbia, SC 29204-2409
Phone (803) 254-2972

Other identifiers 1

IdentifierTypeStateIssuer
Z30850MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060927000535 SC Practitioner - Maxillofacial SurgeryPractitioner - Oral Surgery 2062417942 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial SurgeryAlso: Oral Surgery
Education
Other, 1990
Medicare assignment
May accept Medicare assignment
Group practices
Midlands Oral and Maxillofacial SurgeryGroup PAC ID 7315970365, 4 clinicians

Practice addresses (Care Compare)

1755 Saint Julian PL
Columbia, SC 29204-2409
Phone (803) 254-2972

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3085SCMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Midlands Oral and Maxillofacial Surgery Oral and Maxillofacial Surgery CurrentSince Jul 10, 1995 Accepting new patients

Locations

1073 Pinnacle Point Dr
Columbia, SC 29223
Phone (803) 254-2972

100 Palmetto Health Pkwy
Ste 310
Columbia, SC 29212
Phone (803) 749-0988

1755 Saint Julian Pl
Columbia, SC 29204
Phone (803) 254-2972

2605 Kinard St
Ste 101
Newberry, SC 29108
Phone (803) 254-2972

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1871570804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1755 SAINT JULIAN PL",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042409",
            "telephone_number": "803-254-2972",
            "fax_number": "803-799-2151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 SAINT JULIAN PL",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042409",
            "telephone_number": "803-254-2972",
            "fax_number": "803-799-2151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEVEPAUGH",
        "first_name": "DAVID",
        "middle_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-30",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "SC",
            "license": "3085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Z30850",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.