Sparkle Dental Center Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SPARKLE DENTAL CENTER INC.

Practice address

8848 Highway 17 Byp S
Myrtle Beach, SC 29588-7739

Phone

(843) 650-6700

NPI assigned

Mar 20, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Cameron Julius Banks, PSY.D

Title

President

Phone

(843) 833-3555

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1395273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395273600000",
    "number": "1104243740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1861",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "294421861",
            "telephone_number": "843-833-3555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8848 HIGHWAY 17 BYP S",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295887739",
            "telephone_number": "843-650-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPARKLE DENTAL CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-20",
        "last_updated": "2014-03-20",
        "status": "A",
        "authorized_official_last_name": "BANKS",
        "authorized_official_first_name": "CAMERON",
        "authorized_official_middle_name": "JULIUS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-833-3555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2014; 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.