McClellanville Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MCCLELLANVILLE DENTAL LLC

Practice address

832 Pinckney St
MC Clellanville, SC 29458-9762

Phone

(843) 887-3763

NPI assigned

Jan 14, 2020

Organization subpart

No

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

Authorized official

Name

Laura Varadi, DMDNPI 1962917542

Title

Dentist/Owner

Phone

(843) 345-5870

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Laura Jean Varadi, DMD

  • Dentist
  • MC Clellanville, SC
  • NPI 1962917542
  NPD Authorized official
• Sandra Reid Bigelow

  • General Practice Dentistry
  • McClellanville, SC
  • NPI 1558480764

  General Practice

  NPD (past)

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

{
    "created_epoch": "1578960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578960000000",
    "number": "1194365502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 220",
            "city": "MC CLELLANVILLE",
            "state": "SC",
            "postal_code": "294580220",
            "telephone_number": "843-887-3763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "832 PINCKNEY ST",
            "city": "MC CLELLANVILLE",
            "state": "SC",
            "postal_code": "294589762",
            "telephone_number": "843-887-3763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCCLELLANVILLE DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-14",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A",
        "authorized_official_last_name": "VARADI",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "843-345-5870",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZA9472",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary E English, PT
• Mark Erich, M.D.
• Deborah Ann Fraser, LPC
• Christine Stevens Jackson
• Windsor Florence Lynch, RDN, LD
• McClellanville Physical Therapy, LLC
• Isla Ruth Merritt, R.N.
• Rachel Michi, MS, BCBA
• Evelyn Middleton-Frasier
• Latoya S Middleton

• All providers in MC Clellanville, SC
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2020; 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.