NPIMap

Organization Active NPI

Coastal Oral and Maxillofacial Surgery, PC

  • Oral and Maxillofacial Surgery (Dentist)
  • North Charleston, SC
National Provider Identifier
1093874562
Registry record updated Jun 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
2921 Issued in SC
Legal business name
COASTAL ORAL AND MAXILLOFACIAL SURGERY, PC
Practice address
9221 University Blvd
Building D, Suite 1-a
North Charleston, SC 29406-9148
Phone
(843) 569-0904
Fax
(843) 569-0961
NPI assigned
Dec 8, 2006
Last updated
Jun 22, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2016

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

Authorized official

Name
Dr. Jeffrey S Hall, MD, DMDNPI 1649229956
Title
Practitioner
Phone
(843) 569-0904

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 2921 SC Primary

Addresses

Primary practice location

9221 University Blvd
Building D, Suite 1-a
North Charleston, SC 29406-9148

Mailing address

9221 University Blvd
Building D, Suite 1-a
North Charleston, SC 29406-9148
Phone (843) 569-0904

Other identifiers 1

IdentifierTypeStateIssuer
ZA9890MedicaidSC

Other names 1

  • jeffrey s hall, md, dmd Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466553600000",
    "number": "1093874562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9221 UNIVERSITY BLVD",
            "address_2": "BUILDING D, SUITE 1-A",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069148",
            "telephone_number": "843-569-0904",
            "fax_number": "843-569-0961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9221 UNIVERSITY BLVD",
            "address_2": "BUILDING D, SUITE 1-A",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069148",
            "telephone_number": "843-569-0904",
            "fax_number": "843-569-0961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL ORAL AND MAXILLOFACIAL SURGERY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-08",
        "last_updated": "2016-06-22",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRACTITIONER",
        "authorized_official_telephone_number": "843-569-0904",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "SC",
            "license": "2921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZA9890",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "jeffrey s hall, md, dmd",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in North Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2016; 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.