NPIMap

Organization Active NPI

Gamble Dentalsmart PC

  • General Practice Dentistry
  • Pooler, GA
National Provider Identifier
1114304540
Registry record updated Apr 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
GAMBLE DENTALSMART PC
Practice address
1034 Highway 80
Pooler, GA 31322
Phone
(843) 735-6727
NPI assigned
May 6, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2016

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

Authorized official

Name
Dr. Robert Gamble Jr.
Title
Owner/Dentist
Phone
(843) 614-6769

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

1034 Highway 80
Pooler, GA 31322

Mailing address

2020 Savannah Hwy
Charleston, SC 29407-6286
Phone (843) 614-6769

Other identifiers 1

IdentifierTypeStateIssuer
ZX1626MedicaidSC

Other names 1

  • DentalSmart US Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dentalsmart29 organizations share this tax ID, including this one

Other organizations with this tax ID 28

Organizations that report the same tax identification number in the National Provider Directory.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1430870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460073600000",
    "number": "1114304540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 SAVANNAH HWY",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294076286",
            "telephone_number": "843-614-6769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1034 HIGHWAY 80",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "31322",
            "telephone_number": "843-735-6727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAMBLE DENTALSMART PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-06",
        "last_updated": "2016-04-08",
        "status": "A",
        "authorized_official_last_name": "GAMBLE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "843-614-6769",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZX1626",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DentalSmart US",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pooler, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.