NPIMap

Organization Active NPI

Summer Dental, LLC

  • General Practice Dentistry
  • Summerville, SC
National Provider Identifier
1144634288
Registry record updated Jun 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3440 Issued in SC
Legal business name
SUMMER DENTAL, LLC
Practice address
2039 N Main St
Summerville, SC 29483-7821
Phone
(843) 871-0433
NPI assigned
Jun 17, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2014

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

Authorized official

Name
Mrs. Kim T Durham
Title
Secretary
Phone
(864) 350-1386

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 3440 SC Primary

Addresses

Primary practice location

2039 N Main St
Summerville, SC 29483-7821

Mailing address

130 Meridian Rd
Beaufort, SC 29907-1700
Phone (864) 350-1386

Other names 1

  • Sweetgrass Dental of Summerville Doing business as

National Provider Directory

National Provider Directory

Locations

2039 N Main St
Summerville, SC 29486
Phone (843) 225-1809

Practitioners & affiliated clinicians

Practitioners 4

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": "1402963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402963200000",
    "number": "1144634288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 MERIDIAN RD",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299071700",
            "telephone_number": "864-350-1386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2039 N MAIN ST",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294837821",
            "telephone_number": "843-871-0433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMER DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-17",
        "last_updated": "2014-06-17",
        "status": "A",
        "authorized_official_last_name": "DURHAM",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "864-350-1386",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "3440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sweetgrass Dental of Summerville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 17, 2014; 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.