NPIMap

Organization Active NPI

Dan R Yarbrough,D.M.D.

  • Dentist
  • Walterboro, SC
National Provider Identifier
1306041504
Registry record updated Jun 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2768 Issued in SC
Legal business name
DAN R YARBROUGH,D.M.D.
Practice address
100 Commerce St # a
Walterboro, SC 29488-2943
Phone
(843) 549-7422
Fax
(843) 549-6017
NPI assigned
Jun 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2008

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

Authorized official

Name
Dr. Dan R Yarbrough, D.M.D.
Title
Owner
Phone
(843) 549-7422

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 2768 SC Primary

Addresses

Primary practice location

100 Commerce St # a
Walterboro, SC 29488-2943

Mailing address

100 Commerce St # a
Walterboro, SC 29488-2943
Phone (843) 549-7422

Other identifiers 1

IdentifierTypeStateIssuer
ZA9892MedicaidSC

National Provider Directory

National Provider Directory

Locations

100 Commerce St
#A
Walterboro, SC 29488
Phone (843) 549-7422

NPI Registry JSON

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1306041504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 COMMERCE ST # A",
            "city": "WALTERBORO",
            "state": "SC",
            "postal_code": "294882943",
            "telephone_number": "843-549-7422",
            "fax_number": "843-549-6017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 COMMERCE ST # A",
            "city": "WALTERBORO",
            "state": "SC",
            "postal_code": "294882943",
            "telephone_number": "843-549-7422",
            "fax_number": "843-549-6017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAN R YARBROUGH,D.M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-18",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "YARBROUGH",
        "authorized_official_first_name": "DAN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-549-7422",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "SC",
            "license": "2768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZA9892",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Walterboro, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; 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.