Active NPI
David West Ivey, DMD
- Periodontics
- Summerville, SC
National Provider Identifier
1104935717
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 1692
- Practice address
- 107 West Sixth North Street Suite 102
Summerville, SC 29483 - Phone
- (843) 871-6913
- Fax
- (843) 871-0657
- NPI assigned
- Aug 29, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 1692 | SC | Primary |
Addresses
Primary practice location
107 West Sixth North Street Suite 102
Summerville, SC 29483
Mailing address
107 West Sixth North Street Suite 102
Summerville, SC 29483
Phone (843) 871-6913
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1692 | SC | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104935717",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 WEST SIXTH NORTH STREET SUITE 102",
"city": "SUMMERVILLE",
"state": "SC",
"postal_code": "29483",
"telephone_number": "843-871-6913",
"fax_number": "843-871-0657"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "107 WEST SIXTH NORTH STREET SUITE 102",
"city": "SUMMERVILLE",
"state": "SC",
"postal_code": "29483",
"telephone_number": "843-871-6913",
"fax_number": "843-871-0657"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IVEY",
"first_name": "DAVID",
"middle_name": "WEST",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "SC",
"license": "1692",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Summerville, SC
- Integrated Wellness
- Integro Counseling LLC
- Intrepid of the Lowcountry, Inc. (Intrepid USA Hospice - Low Country)
- Intrepid of the Sandhills, Inc. (Intrepid Palliative & Supportive Care)
- Prat Itharat, M.D.
- Jackson Davenport Vision Services , LLC (Jackson Davnport Vision Center)
- Jackson Davenport Vision, Inc.
- Jackson Pediatric Dentistry of Summerville
- Ebony Louise Jackson
- Mandy Jackson
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.