Serge Gauthier, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DGD.7059 GD Issued in SC

Practice address

513 Red Bank Rd
Goose Creek, SC 29445-4507

Phone

(843) 797-1161

Fax

(843) 797-1162

NPI assigned

Jul 22, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Redbank Family Dentistry

  • General Practice Dentistry
  • Goose Creek, SC
  • NPI 1780066589
  NPD (past) Authorized official

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

{
    "created_epoch": "1311292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446163200000",
    "number": "1215215439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 158",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294450158",
            "telephone_number": "404-451-4888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 RED BANK RD",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294454507",
            "telephone_number": "843-797-1161",
            "fax_number": "843-797-1162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUTHIER",
        "first_name": "SERGE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-22",
        "last_updated": "2015-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "DGD.7059 GD",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZX7059",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gamble Dentalsmart PC
• Cristina Gambrell
• Amanda Ho Van Garrett, DMD
• Mark Richard Garvey, PHARMD
• Melanie Gaskin, MS, CACP
• Alexis Geiter, CCC-SLP
• Deneen Genatt, RDN, LD
• Generation Home Care LLC
• Genesis Healthcare, Inc.
• Laura Elaine Gerber, PT, DPT

• General Practice Dentistry in Goose Creek, SC
• Providers in Goose Creek, SC by specialty
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2015; 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.