Active NPI
Jason Lee Latham, DMD
- Dentist
- Charleston, SC
National Provider Identifier
1083103576
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 8643
- Practice address
- 712 Saint Andrews Blvd
Charleston, SC 29407 - Phone
- (843) 571-5533
- NPI assigned
- May 9, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 8643 | SC | Primary |
Addresses
Primary practice location
712 Saint Andrews Blvd
Charleston, SC 29407
Mailing address
1350 Spring St NW Ste 600
Atlanta, GA 30309-2870
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8643 | SC | MD | Home Health Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1526342400000",
"number": "1083103576",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1350 SPRING ST NW STE 600",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303092870"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "712 SAINT ANDREWS BLVD",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "29407",
"telephone_number": "843-571-5533"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LATHAM",
"first_name": "JASON",
"middle_name": "LEE",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-05-09",
"last_updated": "2018-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "SC",
"license": "8643",
"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 May 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.