Tower Dental, LLC

Primary specialty

DentistTaxonomy code 122300000X

License

4061 Issued in SC

Legal business name

TOWER DENTAL, LLC

Practice address

330 Robert Smalls Pkwy
Suite 11
Beaufort, SC 29906-4237

Phone

(843) 470-0333

NPI assigned

May 28, 2015

Organization subpart

No

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

Authorized official

Name

Jeanine Gourdine, D.M.D.

Title

Owner

Phone

(843) 470-0333

Specialties & licenses 1

Addresses

Other names 1

• Tower Dental Doing business as

Locations

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

{
    "created_epoch": "1432771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432771200000",
    "number": "1114306750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 ROBERT SMALLS PKWY",
            "address_2": "SUITE 11",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299064237",
            "telephone_number": "843-470-0333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 ROBERT SMALLS PKWY",
            "address_2": "SUITE 11",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299064237",
            "telephone_number": "843-470-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWER DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-28",
        "last_updated": "2015-05-28",
        "status": "A",
        "authorized_official_last_name": "GOURDINE",
        "authorized_official_first_name": "JEANINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-470-0333",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "SC",
            "license": "4061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tower Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in Beaufort, SC
• Providers in Beaufort, 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 28, 2015; 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.