Active NPI
Paul M. Doughty D.M.D.
- General Practice Dentistry
- Charleston, SC
National Provider Identifier
1033418314
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 4375
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2X4375 | Medicaid | SC |
National Provider Directory
National Provider DirectoryLocations
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.
-
- General Practice Dentistry
- Charleston, SC
- NPI 1013074822
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.