Individual provider Active NPI

William Justin Crosby, DDS

  • Endodontics
  • Myrtle Beach, SC
National Provider Identifier
1154983690
Registry record updated Oct 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
10299 Issued in SC
Practice address
350 Hilton Rd Ste 201
Myrtle Beach, SC 29572-6623
Phone
(843) 497-3707
NPI assigned
Jul 4, 2019
Last updated
Oct 28, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12013232A IN
Endodontics 1223E0200X 10299 SC Primary

Addresses

Primary practice location

350 Hilton Rd Ste 201
Myrtle Beach, SC 29572-6623

Mailing address

350 Hilton Rd Ste 201
Myrtle Beach, SC 29572-6623
Phone (843) 497-3707

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
12013232AINMDDentist
10299SCMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Myrtle Beach Endodontics, LLC Endodontics CurrentSince Nov 1, 2022 Accepting new patients

Locations

350 Hilton Rd
Ste 201
Myrtle Beach, SC 29572
Phone (843) 497-3707

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1562198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666915200000",
    "number": "1154983690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 HILTON RD STE 201",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295726623",
            "telephone_number": "843-497-3707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 HILTON RD STE 201",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295726623",
            "telephone_number": "843-497-3707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROSBY",
        "first_name": "WILLIAM",
        "middle_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-04",
        "last_updated": "2022-10-28",
        "certification_date": "2022-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12013232A",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "SC",
            "license": "10299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2022; 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.