Loris Family Dentistry, LLC

Primary specialty

DentistTaxonomy code 122300000X

License

SC 4356 Issued in SC

Legal business name

LORIS FAMILY DENTISTRY, LLC

Practice address

3681 Spivey St
Loris, SC 29569-2838

Phone

(843) 756-5747

NPI assigned

May 11, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Craig L Milburn, DMD

Title

President

Phone

(843) 756-5747

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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

• Gwyn Gordon McGutchen

  • General Practice Dentistry
  • Loris, SC
  • NPI 1356684161
  NPD (past)
• George Peter Sourlis, DMD

  • Dentist
  • North Myrtle Beach, SC
  • NPI 1245753714
  NPD (past)
• Daniel Taylor

  • Dentist
  • Loris, SC
  • NPI 1750862405
  NPD (past)

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

{
    "created_epoch": "1462924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462924800000",
    "number": "1104272996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3681 SPIVEY ST",
            "city": "LORIS",
            "state": "SC",
            "postal_code": "295692838",
            "telephone_number": "843-756-5747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3681 SPIVEY ST",
            "city": "LORIS",
            "state": "SC",
            "postal_code": "295692838",
            "telephone_number": "843-756-5747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LORIS FAMILY DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-11",
        "last_updated": "2016-05-11",
        "status": "A",
        "authorized_official_last_name": "MILBURN",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-756-5747",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "SC",
            "license": "SC 4356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Loris Community Hospital District
• Loris Drug Company LLC
• Loris Drug Store, Inc.
• Loris Drug Store, Inc.
• Loris Eye Associates PC
• Loris Medical Center, PA
• Loris Physician Services
• Loris Rehab and Nursing Center, LLC
• Loris Surgical Associates, PA
• Low Country Medical Supply

• Dentist in Loris, SC
• Providers in Loris, SC by specialty
• Dentist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 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.