John Terry Poole III, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3919 Issued in SC

Practice address

1806 Old Trolley Rd
Summerville, SC 29485-8224

Phone

(843) 871-1116

NPI assigned

Oct 4, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Oakbrook Family Dentistry PC

  • Dental Clinic/Center
  • Summerville, SC
  • NPI 1801484704
  NPD Authorized official
• Welvista

  • General Practice Dentistry
  • Fairfax, SC
  • NPI 1033290937
  NPD (past)

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609891200000",
    "number": "1104911346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1806 OLD TROLLEY RD",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294858224",
            "telephone_number": "843-871-1116",
            "fax_number": "843-821-3683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1806 OLD TROLLEY RD",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294858224",
            "telephone_number": "843-871-1116"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3269 Allendale Fairfax Hwy",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "SC",
            "postal_code": "298279163",
            "country_code": "US",
            "telephone_number": "803-584-4803",
            "fax_number": "803-584-4806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POOLE",
        "first_name": "JOHN",
        "middle_name": "TERRY",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2021-01-06",
        "certification_date": "2021-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "3919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZX3919",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erica C Polcari, PA-C
• Frank Gary Polizzi
• Anna Conner Polk, LPC
• Crystal Rose Polk, LISW-CP
• Daniel Poole, M.D.
• Victoria Poole
• Poppins & Co LLC
• Keyonna Marie Porter, NP
• Shawnte S Posley, LPC
• Hope Potter

• General Practice Dentistry in Summerville, SC
• Providers in Summerville, 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 Jan 6, 2021; 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.