Active NPI
Shem Creek Dental Associates
- General Practice Dentistry
- Mount Pleasant, SC
National Provider Identifier
1134598980
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 8323
- Legal business name
- SHEM CREEK DENTAL ASSOCIATES
- Practice address
- 211 Simmons St
Mount Pleasant, SC 29464-4347 - Phone
- (843) 884-5161
- NPI assigned
- Sep 23, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Robert Alan Breault
- Title
- DMD
- Phone
- (843) 884-5161
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 8323 | SC | Primary |
Addresses
Primary practice location
211 Simmons St
Mount Pleasant, SC 29464-4347
Mailing address
211 Simmons St
Mount Pleasant, SC 29464-4347
Phone (843) 884-5161
National Provider Directory
National Provider DirectoryLocations
211 Simmons St
Mt Pleasant, SC 29464
Phone (843) 884-5161
Practitioners & affiliated clinicians
Practitioners 1
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": "1442966400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1442966400000",
"number": "1134598980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "211 SIMMONS ST",
"city": "MOUNT PLEASANT",
"state": "SC",
"postal_code": "294644347",
"telephone_number": "843-884-5161"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "211 SIMMONS ST",
"city": "MOUNT PLEASANT",
"state": "SC",
"postal_code": "294644347",
"telephone_number": "843-884-5161"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SHEM CREEK DENTAL ASSOCIATES",
"organizational_subpart": "NO",
"enumeration_date": "2015-09-23",
"last_updated": "2015-09-23",
"status": "A",
"authorized_official_last_name": "BREAULT",
"authorized_official_first_name": "ROBERT",
"authorized_official_middle_name": "ALAN",
"authorized_official_title_or_position": "DMD",
"authorized_official_telephone_number": "843-884-5161",
"authorized_official_name_prefix": "Dr."
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": "SC",
"license": "8323",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mount Pleasant, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.