Individual provider Active NPI

Frances Gouldin, DDS

  • Pediatric Dentistry
  • Mount Pleasant, SC
National Provider Identifier
1205489739
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
10902 Issued in SC
Practice address
1130 Professional LN
Mt Pleasant, SC 29466-7193
Phone
(216) 587-9843
NPI assigned
Jul 23, 2019
Last updated
Sep 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 9423 SC
Pediatric Dentistry 1223P0221X 10902 SC Primary

Addresses

Primary practice location

1130 Professional LN
Mt Pleasant, SC 29466-7193

Mailing address

1130 Professional LN
Mt Pleasant, SC 29466-7193

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221115002986 SC Order and Referring Only - DentistPractitioner - Other (Physician)Practitioner - Dentist 1759759137

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10902SCMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1563840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1205489739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 PROFESSIONAL LN",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294667193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 PROFESSIONAL LN",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294667193",
            "telephone_number": "216-587-9843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOULDIN",
        "first_name": "FRANCES",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-23",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "9423",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "SC",
            "license": "10902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, SC

Sources for this page

Verify at the official NPI Registry.