Teeth DS Isle of Palms

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

TEETH DS ISLE OF PALMS

Practice address

15 21St Ave
Isle of Palms, SC 29451-2384

Phone

(843) 886-6461

Fax

(843) 886-3957

NPI assigned

Oct 26, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Luke Liszka, DMD

Title

Owner

Phone

(843) 886-6461

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Tax ID family

Teeth DS Isle of Palms2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Teeth DS Isle of Palms

  • Endodontics
  • Isle of Palms, SC
  • NPI 1144002791
  NPD tax ID

Interoperability endpoints

• Direct secure messaging: iop@teethds.com

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Teeth DS Isle of Palms

  • Endodontics
  • Isle of Palms, SC
  • NPI 1144002791
  NPPES parent name

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

{
    "created_epoch": "1603670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603670400000",
    "number": "1386244846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 347",
            "city": "ISLE OF PALMS",
            "state": "SC",
            "postal_code": "294510347",
            "telephone_number": "843-886-6461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 21ST AVE",
            "city": "ISLE OF PALMS",
            "state": "SC",
            "postal_code": "294512384",
            "telephone_number": "843-886-6461",
            "fax_number": "843-886-3957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEETH DS ISLE OF PALMS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-26",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A",
        "authorized_official_last_name": "LISZKA",
        "authorized_official_first_name": "LUKE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-886-6461",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL",
            "identifier": "9325",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "IOP@teethds.com",
            "affiliation": "N",
            "address_1": "15 21st Ave",
            "city": "Isle Of Palms",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294512384",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• William Rayburn, MD, MBA
• Caroline Rice
• Elissa Reilly Slater, BSN RN
• Caroline Sledden, RDN, LDN
• Teeth DS Isle of Palms
• The Island Doctor
• Tide Life Therapy LLC
• Richard George Wagner Jr., M.D.
• Lindsay Williams, ED.S.

• Dental Clinic/Center in Isle of Palms, SC
• Providers in Isle of Palms, SC by specialty
• Dental Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.