NPIMap

Organization Active NPI

Muscdental Faculty Practice

  • General Practice Dentistry
  • Charleston, SC
National Provider Identifier
1326166240
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MUSCDENTAL FACULTY PRACTICE
Practice address
173 Ashley Ave
BSB 346
Charleston, SC 29425-0001
Phone
(843) 792-3444
Fax
(843) 792-0348
NPI assigned
Mar 27, 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
Philip J. Blacklocke
Title
Business Manager
Phone
(843) 792-8330

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X SC Primary

Addresses

Primary practice location

173 Ashley Ave
BSB 346
Charleston, SC 29425-0001

Mailing address

173 Ashley Ave
BSB 346
Charleston, SC 29425-0001
Phone (843) 792-3444

National Provider Directory

National Provider Directory
Tax ID family
Medical University of South13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

173 Ashley Ave
#346
Charleston, SC 29425
Phone (843) 792-3444

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": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1326166240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "173 ASHLEY AVE",
            "address_2": "BSB 346",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294250001",
            "telephone_number": "843-792-3444",
            "fax_number": "843-792-0348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "173 ASHLEY AVE",
            "address_2": "BSB 346",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294250001",
            "telephone_number": "843-792-3444",
            "fax_number": "843-792-0348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUSCDENTAL FACULTY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BLACKLOCKE",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "843-792-8330"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, 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.