Individual provider Active NPI

Vatsal Suthar, D.M.D.

  • General Practice Dentistry
  • Sumter, SC
National Provider Identifier
1902141682
Registry record updated Apr 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8125 Issued in SC
Practice address
625 Constitution Dr
Sumter, SC 29154-8190
Phone
(803) 773-5413
NPI assigned
Dec 6, 2012
Last updated
Apr 18, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 8125 SC Primary

Addresses

Primary practice location

625 Constitution Dr
Sumter, SC 29154-8190

Mailing address

625 Constitution Dr
Sumter, SC 29154-8190
Phone (803) 773-5413

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160429000657 SC Order and Referring Only - DentistPractitioner - Dentist 8426357245

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8125SCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Arian L. Ray DDS PA General Practice Past Accepting new patients
Omni Dental of Sumter LLC PastSince Nov 10, 2024 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1354752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460937600000",
    "number": "1902141682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 CONSTITUTION DR",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291548190",
            "telephone_number": "803-773-5413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 CONSTITUTION DR",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291548190",
            "telephone_number": "803-773-5413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTHAR",
        "first_name": "VATSAL",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-06",
        "last_updated": "2016-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "8125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sumter, SC

Sources for this page

Verify at the official NPI Registry.