NPIMap

Organization Active NPI

Periodontal Associates LLC

  • Periodontics
  • Charleston, SC
National Provider Identifier
1013288786
Registry record updated Jan 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
3981 Issued in SC
Legal business name
PERIODONTAL ASSOCIATES LLC
Practice address
33 Gamecock Ave Ste a
Charleston, SC 29407-3397
Phone
(843) 571-0853
Fax
(843) 769-7342
NPI assigned
Jan 26, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2012

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

Authorized official

Name
Dr. Edward Thomas Murphy, DMDNPI 1568585743
Title
Member
Phone
(843) 571-0853

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0300X 1487 SC
PeriodonticsGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0300X 3204 SC
PeriodonticsGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0300X 3981 SC Primary

Addresses

Primary practice location

33 Gamecock Ave Ste a
Charleston, SC 29407-3397

Mailing address

33 Gamecock Ave Ste a
Charleston, SC 29407-3397
Phone (843) 571-0853

National Provider Directory

National Provider Directory

Locations

33 Gamecock Ave
Ste A
Charleston, SC 29407
Phone (843) 571-0853

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1327536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327536000000",
    "number": "1013288786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 GAMECOCK AVE STE A",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294073397",
            "telephone_number": "843-571-0853",
            "fax_number": "843-769-7342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 GAMECOCK AVE STE A",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294073397",
            "telephone_number": "843-571-0853",
            "fax_number": "843-769-7342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERIODONTAL ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-26",
        "last_updated": "2012-01-26",
        "status": "A",
        "authorized_official_last_name": "MURPHY",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "843-571-0853",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "SC",
            "license": "1487",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "SC",
            "license": "3204",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "SC",
            "license": "3981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.