Organization Active NPI

Shem Creek Dental Associates

  • General Practice Dentistry
  • Mount Pleasant, SC
National Provider Identifier
1134598980
Registry record updated Sep 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8323 Issued in SC
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

Updated by the provider on Sep 23, 2015

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)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 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 Directory

Locations

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.

Verify at the official NPI Registry.