Riccobene & Associates Ccci, DDS, PC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

RICCOBENE & ASSOCIATES CCCI, DDS, PC

Practice address

900 Highway 17 N Ste E
North Myrtle Beach, SC 29582-2804

Phone

(843) 491-6021

NPI assigned

Sep 27, 2023

Organization subpart

No

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

Authorized official

Name

Michael Riccobene

Title

Ceo

Phone

(855) 417-4226

Specialties & licenses 1

Addresses

Other names 1

• Brush and Floss North Myrtle Beach Doing business as

Tax ID family

Brush and Floss North Myrtle Beach2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Riccobene & Associates Ccci, DDS, PC

  • Oral and Maxillofacial Surgery (Dentist)
  • North Myrtle Beach, SC
  • NPI 1891625265
  NPD tax ID

Locations

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

{
    "created_epoch": "1695772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701216000000",
    "number": "1205615341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749625",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303749625",
            "telephone_number": "910-853-6172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 HIGHWAY 17 N STE E",
            "city": "NORTH MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295822804",
            "telephone_number": "843-491-6021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICCOBENE & ASSOCIATES CCCI, DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-27",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A",
        "authorized_official_last_name": "RICCOBENE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "855-417-4226"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brush and Floss North Myrtle Beach",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Reach Community Support, LLC
• Jennifer R Reed
• Patricia Reich, LMT
• Ronald K Reynolds, M.D.
• Riccobene & Associates CCC DDS PC
• Riccobene & Associates Ccci, DDS, PC
• Mattie Carolyn Rich, RBT
• Riesenberg Family Dental, LLC
• Sean Patrick Riley, RN
• Amanda Dawn Ritz, M.ED., MS., LPC

• Oral and Maxillofacial Surgery (Dentist) in North Myrtle Beach, SC
• Providers in North Myrtle Beach, SC by specialty
• Oral and Maxillofacial Surgery (Dentist) in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; 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.