Organization Active NPI

Exemplar Oral Surgery Center

  • Oral and Maxillofacial Surgery (Dentist)
  • North Charleston, SC
National Provider Identifier
1124616974
Registry record updated Jul 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
EXEMPLAR ORAL SURGERY CENTER
Practice address
4986 Calvin St
North Charleston, SC 29418-5902
Phone
(843) 408-4808
Fax
(843) 408-4614
NPI assigned
Jan 7, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2021

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

Authorized official

Name
Dr. Daniel Leach, DMDNPI 1366706954
Title
Doctor
Phone
(843) 408-4808

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X Primary

Addresses

Primary practice location

4986 Calvin St
North Charleston, SC 29418-5902

Mailing address

4986 Calvin St
North Charleston, SC 29418-5902
Phone (843) 408-4808

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D2322475Exemplar Oral Surgery Center4986 Calvin Street, North Charleston, SC 29418Certificate of waiverApr 21, 2027

National Provider Directory

National Provider Directory

Locations

4986 Calvin St
North Charleston, SC 29418
Phone (843) 408-4808

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1609977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627344000000",
    "number": "1124616974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4986 CALVIN ST",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294185902",
            "telephone_number": "843-408-4808",
            "fax_number": "843-408-4614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4986 CALVIN ST",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294185902",
            "telephone_number": "843-408-4808",
            "fax_number": "843-408-4614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXEMPLAR ORAL SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-07",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-27",
        "status": "A",
        "authorized_official_last_name": "LEACH",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "843-408-4808",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.