Organization Active NPI

Paul M. Doughty D.M.D.

  • General Practice Dentistry
  • Charleston, SC
National Provider Identifier
1033418314
Registry record updated Mar 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4375 Issued in SC
Legal business name
PAUL M. DOUGHTY D.M.D.
Practice address
18 Leinbach Dr Ste a
Charleston, SC 29407-7916
Phone
(843) 766-0610
NPI assigned
Mar 25, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2011

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

Authorized official

Name
Dr. Paul Martin Doughty, D.M.D.
Title
Owner/Dentist
Phone
(843) 766-0610

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 4375 SC Primary

Addresses

Primary practice location

18 Leinbach Dr Ste a
Charleston, SC 29407-7916

Mailing address

18 Leinbach Dr Ste a
Charleston, SC 29407-7916
Phone (843) 766-0610

Other identifiers 1

IdentifierTypeStateIssuer
2X4375MedicaidSC

National Provider Directory

National Provider Directory

Locations

18 Leinbach Dr
Ste A
Charleston, SC 29407
Phone (843) 766-0610

Practitioners & affiliated clinicians

Practitioners 1

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": "1301011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301011200000",
    "number": "1033418314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 LEINBACH DR STE A",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294077916",
            "telephone_number": "843-766-0610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 LEINBACH DR STE A",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294077916",
            "telephone_number": "843-766-0610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL M. DOUGHTY D.M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-25",
        "last_updated": "2011-03-25",
        "status": "A",
        "authorized_official_last_name": "DOUGHTY",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "MARTIN",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "843-766-0610",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "4375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2X4375",
            "state": "SC"
        }
    ],
    "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 Mar 25, 2011; 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.