Individual provider Active NPI

Daniel Lucien Cassidy Jr.

  • General Practice Dentistry
  • Hilton Head Island, SC
National Provider Identifier
1356974513
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9721 Issued in SC
Practice address
3 Palmetto Business Park Rd
Hilton Head Island, SC 29928-3235
Phone
(478) 737-6098
NPI assigned
Feb 17, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X DGD.9721GD SC
General Practice Dentistry 1223G0001X 9721 SC Primary

Addresses

Primary practice location

3 Palmetto Business Park Rd
Hilton Head Island, SC 29928-3235

Mailing address

3 Palmetto Business Park Rd
Hilton Head Island, SC 29928-3235
Phone (843) 341-3900

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
9721SCMDProfessional Counselor
DGD.9721GDSCMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Center for Advanced Dentistry Murrells Inlet, LLC PastSince Jul 1, 2024 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": "1581897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1356974513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 PALMETTO BUSINESS PARK RD",
            "city": "HILTON HEAD ISLAND",
            "state": "SC",
            "postal_code": "299283235",
            "telephone_number": "843-341-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 PALMETTO BUSINESS PARK RD",
            "city": "HILTON HEAD ISLAND",
            "state": "SC",
            "postal_code": "299283235",
            "telephone_number": "478-737-6098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASSIDY",
        "first_name": "DANIEL",
        "middle_name": "LUCIEN",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-02-17",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "SC",
            "license": "DGD.9721GD",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "9721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hilton Head Island, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2025; 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.