Active NPI
Gamble Dentalsmart PC
Doing business as DentalSmart
- General Practice Dentistry
- Conway, SC
National Provider Identifier
1003275306
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- Legal business name
- GAMBLE DENTALSMART PC
- Doing business as
- DentalSmart
- Practice address
- 2676 Church St
Conway, SC 29526-4471 - Phone
- (843) 735-6727
- NPI assigned
- Feb 15, 2016
- Last updated
- Apr 12, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Robert Gamble Jr.
- Title
- Dentist/Owner
- Phone
- (843) 735-6727
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | Primary |
Addresses
Primary practice location
2676 Church St
Conway, SC 29526-4471
Mailing address
2020 Savannah Hwy
Charleston, SC 29407-6286
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1626 | Medicaid | SC |
Other names 1
- DentalSmart
National Provider Directory
National Provider Directory- Tax ID family
- Dentalsmart
Other organizations with this tax ID 28
Organizations that report the same tax identification number in the National Provider Directory.
-
dba DentalSmart
- General Practice Dentistry
- North Charleston, SC
- NPI 1144685330
Locations
2676 Church St
Conway, SC 29526
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1455494400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1460419200000",
"number": "1003275306",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2020 SAVANNAH HWY",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294076286"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2676 CHURCH ST",
"city": "CONWAY",
"state": "SC",
"postal_code": "295264471",
"telephone_number": "843-735-6727"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GAMBLE DENTALSMART PC",
"organizational_subpart": "NO",
"enumeration_date": "2016-02-15",
"last_updated": "2016-04-12",
"status": "A",
"authorized_official_last_name": "GAMBLE",
"authorized_official_first_name": "ROBERT",
"authorized_official_title_or_position": "DENTIST/OWNER",
"authorized_official_telephone_number": "843-735-6727",
"authorized_official_name_suffix": "Jr."
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1626",
"state": "SC"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "DentalSmart",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Conway, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.