Active NPI
Walter Renne, DMD
- Dentist
- Charleston, SC
National Provider Identifier
1184873671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 4491
- Practice address
- 171 Ashley Ave
Room 346
Charleston, SC 29425-8908 - Phone
- (843) 743-9465
- NPI assigned
- Sep 9, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 4491 | SC | Primary |
Addresses
Primary practice location
171 Ashley Ave
Room 346
Charleston, SC 29425-8908
Mailing address
171 Ashley Ave
Room 346
Charleston, SC 29425-8908
Phone (843) 743-9465
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4491 | SC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1220918400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1220918400000",
"number": "1184873671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "171 ASHLEY AVE",
"address_2": "ROOM 346",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294258908",
"telephone_number": "843-743-9465"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "171 ASHLEY AVE",
"address_2": "ROOM 346",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294258908",
"telephone_number": "843-743-9465"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENNE",
"first_name": "WALTER",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-09-09",
"last_updated": "2008-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "SC",
"license": "4491",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.