Coastal Endontics, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

3662 Issued in SC

Legal business name

COASTAL ENDONTICS, LLC

Practice address

277B Willbrook Boulevard
Pawleys Island, SC 29585-8776

Phone

(843) 235-9780

Fax

(843) 235-8444

NPI assigned

Nov 16, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Russell S Eddy, DMDNPI 1477501575

Title

Member

Phone

(843) 235-9780

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Russell S. Eddy, DMD

  • Endodontics
  • Pawley's Island, SC
  • NPI 1477501575
  NPD (past) Authorized official

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

{
    "created_epoch": "1195171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195171200000",
    "number": "1093996282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4776",
            "city": "PAWLEYS ISLAND",
            "state": "SC",
            "postal_code": "295858776",
            "telephone_number": "843-235-9780",
            "fax_number": "843-235-8444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "277B WILLBROOK BOULEVARD",
            "city": "PAWLEYS ISLAND",
            "state": "SC",
            "postal_code": "295858776",
            "telephone_number": "843-235-9780",
            "fax_number": "843-235-8444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL ENDONTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-16",
        "last_updated": "2007-11-16",
        "status": "A",
        "authorized_official_last_name": "EDDY",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "843-235-9780",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "SC",
            "license": "3662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Franklin E Clemons, Jr., L.P.C.
• Katherine Close, MD
• Coastal Carolina Mobile Physicians
• Coastal Chiropractic Clinic
• Coastal Ear Nose & Throat PC
• Coastal Hearing Center Inc
• Coastal Home Care (American HomePatient)
• Coastal Med, LLC
• Coastal Physical Therapy Group, LLC
• Coastal Recovery of South Carolina

• Dental Clinic/Center in Pawley's Island, SC
• Providers in Pawley's Island, SC by specialty
• Dental Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2007; 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.