Individual provider Active NPI

John B Goolsby, DMD

  • General Practice Dentistry
  • Charleston, SC
National Provider Identifier
1104983501
Registry record updated Sep 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
550813168 Issued in SC
Practice address
537 Wappoo Rd
Charleston, SC 29407-2223
Phone
(843) 571-5656
Fax
(843) 571-2422
NPI assigned
Jan 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 550813168 SC Primary

Addresses

Primary practice location

537 Wappoo Rd
Charleston, SC 29407-2223

Mailing address

537 Wappoo Rd
Charleston, SC 29407-2223
Phone (843) 571-5656

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

LicenseStateTypeSpecialty
550813168SCMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788912000000",
    "number": "1104983501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "537 WAPPOO RD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294072223",
            "telephone_number": "843-571-5656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "537 WAPPOO RD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294072223",
            "telephone_number": "843-571-5656",
            "fax_number": "843-571-2422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOOLSBY",
        "first_name": "JOHN",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "550813168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2026; 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.