NPIMap

Organization Active NPI

SFD Carnes LLC

  • General Practice Dentistry
  • Summerville, SC
National Provider Identifier
1144762576
Registry record updated Feb 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8091 Issued in SC
Legal business name
SFD CARNES LLC
Practice address
110 Parish Farms Dr
Summerville, SC 29486-0409
Phone
(843) 300-1635
Fax
(843) 300-1639
NPI assigned
Nov 16, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2017

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

Authorized official

Name
Mrs. Angela M Bazzle
Title
Operations Manager
Phone
(843) 871-0842

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 8091 SC Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 3352 SC

Addresses

Primary practice location

110 Parish Farms Dr
Summerville, SC 29486-0409

Mailing address

1971 N Main St
Summerville, SC 29486-7820
Phone (843) 871-0842

Other identifiers 2

IdentifierTypeStateIssuer
Z33526MedicaidSC
ZX8091MedicaidSC

National Provider Directory

National Provider Directory

Locations

110 Parish Farms Dr
Summerville, SC 29486
Phone (843) 300-1635

Practitioners & affiliated clinicians

Practitioners 6

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": "1479254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486512000000",
    "number": "1144762576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1971 N MAIN ST",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294867820",
            "telephone_number": "843-871-0842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 PARISH FARMS DR",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294860409",
            "telephone_number": "843-300-1635",
            "fax_number": "843-300-1639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SFD CARNES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-16",
        "last_updated": "2017-02-08",
        "status": "A",
        "authorized_official_last_name": "BAZZLE",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "843-871-0842",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "8091",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "3352",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Z33526",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZX8091",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Feb 8, 2017; 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.