Active NPI
Charles Moore, DMD
- Dentist
- Summerville, SC
National Provider Identifier
1114336310
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 8530
- Practice address
- 1710 Trolley Rd Ste B
Summerville, SC 29485-8281 - Phone
- (843) 871-0711
- NPI assigned
- Aug 13, 2014
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 8530 | SC | Primary |
Addresses
Primary practice location
1710 Trolley Rd Ste B
Summerville, SC 29485-8281
Mailing address
1710 Trolley Rd Ste B
Summerville, SC 29485-8281
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 |
|---|---|---|---|
| 8530 | SC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407888000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1441152000000",
"number": "1114336310",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1710 TROLLEY RD STE B",
"city": "SUMMERVILLE",
"state": "SC",
"postal_code": "294858281"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1710 TROLLEY RD STE B",
"city": "SUMMERVILLE",
"state": "SC",
"postal_code": "294858281",
"telephone_number": "843-871-0711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "CHARLES",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-08-13",
"last_updated": "2015-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "SC",
"license": "8530",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Summerville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 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.