NPIMap

Organization Active NPI

DRS. Kunkle and Powell, PA

  • General Practice Dentistry
  • Moncks Corner, SC
National Provider Identifier
1396963443
Registry record updated Sep 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3119 SC Issued in SC
Legal business name
DRS. KUNKLE AND POWELL, PA
Practice address
119 Library St
Moncks Corner, SC 29461-3751
Phone
(843) 761-8065
Fax
(843) 761-5085
NPI assigned
Apr 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2023

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

Authorized official

Name
Dr. Suzanne Sprouse Powell, DMD
Title
Co-Owner/General Dentist
Phone
(843) 761-8065

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 3119 SC SC Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 1641 SC SC

Addresses

Primary practice location

119 Library St
Moncks Corner, SC 29461-3751

Mailing address

119 Library St
Moncks Corner, SC 29461-3751
Phone (843) 761-8065

Other identifiers 1

IdentifierTypeStateIssuer
ZA9778MedicaidSC

National Provider Directory

National Provider Directory

Locations

119 Library St
Moncks Corner, SC 29461
Phone (843) 761-8065

Practitioners & affiliated clinicians

Practitioners 3

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": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695081600000",
    "number": "1396963443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 LIBRARY ST",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294613751",
            "telephone_number": "843-761-8065",
            "fax_number": "843-761-5085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 LIBRARY ST",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294613751",
            "telephone_number": "843-761-8065",
            "fax_number": "843-761-5085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRS. KUNKLE AND POWELL, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2023-09-19",
        "status": "A",
        "authorized_official_last_name": "POWELL",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_middle_name": "SPROUSE",
        "authorized_official_title_or_position": "CO-OWNER/GENERAL DENTIST",
        "authorized_official_telephone_number": "843-761-8065",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "3119 SC",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "1641 SC",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZA9778",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moncks Corner, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; 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.