Michael Chase Cappellucci, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DGD.10158 Issued in SC

Practice address

82ND Pkwy and N Kings Hwy
Myrtle Beach, SC 29572

Phone

(630) 699-1537

NPI assigned

May 31, 2022

Last updated

May 31, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Leesville Dental, PA

  • General Practice Dentistry
  • Batesburg Leesville, SC
  • NPI 1073462321
  NPD Authorized official
• Little Mountain Dental, PA

  • Dental Clinic/Center
  • Little Mountain, SC
  • NPI 1548194285
  NPD Authorized official

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

{
    "created_epoch": "1653955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1285373159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 A S OCEAN BLVD",
            "city": "SURFSIDE BEACH",
            "state": "SC",
            "postal_code": "29575",
            "telephone_number": "385-282-8746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82ND PKWY AND N KINGS HWY",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "29572",
            "telephone_number": "630-699-1537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPPELLUCCI",
        "first_name": "MICHAEL",
        "middle_name": "CHASE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-31",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "DGD.10158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Cangeme
• Marc Anthony Cannella
• Kayla Alexandria Canteen, FNP-BC
• Capeside Addiction Care, PLLC
• Frances M Caporale-Snyder
• Kenneth Thomas Cappuccio, LCSW
• Augustin Cardona, LAC
• Carehere, LLC
• Carey Counseling, LLC
• Victoria Carey, MSW, LISW-CP

• General Practice Dentistry in Myrtle Beach, SC
• Providers in Myrtle Beach, 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 May 31, 2022; 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.