Active NPI
Timothy Ivan McConnell, D.M.D.
- General Practice Dentistry
- Goose Creek, SC
National Provider Identifier
1235187501
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 1759
- Practice address
- 100 Berkeley Square LN
Goose Creek, SC 29445-2958 - Phone
- (843) 553-5235
- Fax
- (843) 797-8189
- NPI assigned
- May 5, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 1759 | SC | Primary |
Addresses
Primary practice location
100 Berkeley Square LN
Goose Creek, SC 29445-2958
Mailing address
PO Box 1120
Goose Creek, SC 29445-1120
Phone (843) 553-5235
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Z17599 | Medicaid | SC | |
| 79343 | Other | SC | UNITED CONCORDIA INSURANC |
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 |
|---|---|---|---|
| 1759 | SC | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1235187501",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1120",
"city": "GOOSE CREEK",
"state": "SC",
"postal_code": "294451120",
"telephone_number": "843-553-5235",
"fax_number": "843-797-8189"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 BERKELEY SQUARE LN",
"city": "GOOSE CREEK",
"state": "SC",
"postal_code": "294452958",
"telephone_number": "843-553-5235",
"fax_number": "843-797-8189"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCONNELL",
"first_name": "TIMOTHY",
"middle_name": "IVAN",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-05",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "SC",
"license": "1759",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "Z17599",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA INSURANC",
"identifier": "79343",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Goose Creek, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.