NPIMap

Organization Active NPI

Spacey'S Tooth Shoppe, Inc

  • General Practice Dentistry
  • Johns Island, SC
National Provider Identifier
1295851236
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
SC2958 Issued in SC
Legal business name
SPACEY'S TOOTH SHOPPE, INC
Practice address
3201 Maybank Hwy
Johns Island, SC 29455-4817
Phone
(843) 559-3135
NPI assigned
Mar 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Eugene Dennis Spacey, DMDNPI 1073769600
Title
President
Phone
(843) 559-3135

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X SC2958 SC Primary

Addresses

Primary practice location

3201 Maybank Hwy
Johns Island, SC 29455-4817

Mailing address

3201 Maybank Hwy
Johns Island, SC 29455-4817
Phone (843) 559-3135

National Provider Directory

National Provider Directory

Locations

3201 Maybank Hwy
Johns Island, SC 29455
Phone (843) 559-3135

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295851236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 MAYBANK HWY",
            "city": "JOHNS ISLAND",
            "state": "SC",
            "postal_code": "294554817",
            "telephone_number": "843-559-3135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 MAYBANK HWY",
            "city": "JOHNS ISLAND",
            "state": "SC",
            "postal_code": "294554817",
            "telephone_number": "843-559-3135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPACEY'S TOOTH SHOPPE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SPACEY",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_middle_name": "DENNIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-559-3135",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "SC2958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johns Island, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.