NPIMap

Organization Active NPI

Nicholas J Pournaras DMD LLC

  • General Practice Dentistry
  • Cayce, SC
National Provider Identifier
1083770762
Registry record updated Jun 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3552 Issued in SC
Legal business name
NICHOLAS J POURNARAS DMD LLC
Practice address
1801A Charleston Highway
Cayce, SC 29033
Phone
(803) 794-5430
Fax
(803) 794-0122
NPI assigned
Dec 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2008

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

Authorized official

Name
Dr. Nicholas J Pournaras, DMDNPI 1629289731
Title
Owner President
Phone
(803) 794-5430

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 3552 SC Primary

Addresses

Primary practice location

1801A Charleston Highway
Cayce, SC 29033

Mailing address

1801A Charleston Highway
Cayce, SC 29033
Phone (803) 794-5430

Other identifiers 1

IdentifierTypeStateIssuer
ZA9845MedicaidSC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1083770762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801A CHARLESTON HIGHWAY",
            "city": "CAYCE",
            "state": "SC",
            "postal_code": "29033",
            "telephone_number": "803-794-5430",
            "fax_number": "803-794-0122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801A CHARLESTON HIGHWAY",
            "city": "CAYCE",
            "state": "SC",
            "postal_code": "29033",
            "telephone_number": "803-794-5430",
            "fax_number": "803-794-0122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICHOLAS J POURNARAS DMD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "POURNARAS",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "803-794-5430",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "3552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZA9845",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cayce, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; 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.