NPIMap

Organization Active NPI

Dental Professionals of South Carolina, PC

Doing business as Smiles at Goose Creek

  • General Practice Dentistry
  • Goose Creek, SC
National Provider Identifier
1295195188
Registry record updated Mar 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL PROFESSIONALS OF SOUTH CAROLINA, PC
Doing business as
Smiles at Goose Creek
Practice address
615 St. James Ave
Goose Creek, SC 29445
Phone
(843) 804-6927
NPI assigned
Mar 4, 2016
Last updated
Mar 4, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
DENTAL PROFESSIONALS OF SOUTH CAROLINA, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 4, 2016

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

Authorized official

Name
Kendra Walker
Title
Credentialing Team Lead
Phone
(217) 540-8312

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X Primary

Addresses

Primary practice location

615 St. James Ave
Goose Creek, SC 29445

Mailing address

615 St. James Ave
Goose Creek, SC 29445

Other names 1

  • Smiles at Goose Creek Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dental Professional of SC74 organizations share this tax ID, including this one
Part of
Dental Professional of SC

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

615 Saint James Ave
Goose Creek, SC 29445
Phone (843) 285-5950

NPI Registry JSON

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

{
    "created_epoch": "1457049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457049600000",
    "number": "1295195188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 ST. JAMES AVE",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "29445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 ST. JAMES AVE",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "29445",
            "telephone_number": "843-804-6927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL PROFESSIONALS OF SOUTH CAROLINA, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL PROFESSIONALS OF SOUTH CAROLINA, PC",
        "enumeration_date": "2016-03-04",
        "last_updated": "2016-03-04",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "KENDRA",
        "authorized_official_title_or_position": "CREDENTIALING TEAM LEAD",
        "authorized_official_telephone_number": "217-540-8312"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smiles at Goose Creek",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 4, 2016; 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.