NPIMap

Organization Active NPI

Philip Prickett/ Mt. Pleasant Oral Facial & Implant

  • Oral and Maxillofacial Surgery (Dentist)
  • Mt Pleasant, SC
National Provider Identifier
1144370339
Registry record updated Jun 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
3132 Issued in SC
Legal business name
PHILIP PRICKETT/ MT. PLEASANT ORAL FACIAL & IMPLANT
Practice address
1311 Chuck Dawley Blvd Ste 101
Mt Pleasant, SC 29464-7303
Phone
(843) 971-0041
Fax
(843) 971-0043
NPI assigned
Jan 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2008

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

Authorized official

Name
Dr. Philip M Prickett, D.M.D.
Title
Physician
Phone
(843) 971-0041

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X 3132 SC Primary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X 1481 SC

Addresses

Primary practice location

1311 Chuck Dawley Blvd Ste 101
Mt Pleasant, SC 29464-7303

Mailing address

7465A Northside Dr
Charleston, SC 29420-4209
Phone (843) 797-7600

Other identifiers 1

IdentifierTypeStateIssuer
ZA9913MedicaidSC

Other names 1

  • Low Country Oral Facial & Implant Doing business as

National Provider Directory

National Provider Directory

Locations

1311 Chuck Dawley Blvd
Ste 101
Mt Pleasant, SC 29464
Phone (843) 971-0041

7465 Northside Dr
Ste A
North Charleston, SC 29420
Phone (803) 797-7600

Practitioners & affiliated clinicians

Practitioners 3

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": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214438400000",
    "number": "1144370339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7465A NORTHSIDE DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294204209",
            "telephone_number": "843-797-7600",
            "fax_number": "843-797-7905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 CHUCK DAWLEY BLVD STE 101",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294647303",
            "telephone_number": "843-971-0041",
            "fax_number": "843-971-0043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILIP PRICKETT/ MT. PLEASANT ORAL FACIAL & IMPLANT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2008-06-26",
        "status": "A",
        "authorized_official_last_name": "PRICKETT",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "843-971-0041",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "SC",
            "license": "3132",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "SC",
            "license": "1481",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZA9913",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Low Country Oral Facial & Implant",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mt Pleasant, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2008; 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.