NPIMap

Individual provider Active NPI

Stephen F Tuttle, DDS

  • Dentist
  • Myrtle Beach, SC
National Provider Identifier
1316973357
Registry record updated Feb 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4159 Issued in VA
Practice address
3012 Newcastle Loop
Myrtle Beach, SC 29588-4501
Phone
(843) 215-2599
Fax
(843) 215-0238
NPI assigned
Jun 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 4159 VA Primary

Addresses

Primary practice location

3012 Newcastle Loop
Myrtle Beach, SC 29588-4501

Mailing address

3012 Newcastle Loop
Myrtle Beach, SC 29588-4501
Phone (843) 215-2599

Other identifiers 1

IdentifierTypeStateIssuer
ZX4159MedicaidSC

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

LicenseStateTypeSpecialty
4159VAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Village Family Dental Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202083200000",
    "number": "1316973357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3012 NEWCASTLE LOOP",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295884501",
            "telephone_number": "843-215-2599",
            "fax_number": "843-215-0238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3012 NEWCASTLE LOOP",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295884501",
            "telephone_number": "843-215-2599",
            "fax_number": "843-215-0238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUTTLE",
        "first_name": "STEPHEN",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2008-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "4159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZX4159",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 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.