Active NPI
Eric Conrad Horecky, D.M.D.
- General Practice Dentistry
- Mt Pleasant, SC
National Provider Identifier
1417027152
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 3573
- Practice address
- 152 Civitas St
Suite 200
Mt Pleasant, SC 29464-6692 - Phone
- (843) 388-0059
- Fax
- (843) 388-0019
- NPI assigned
- Nov 9, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 3573 | SC | Primary |
Addresses
Primary practice location
152 Civitas St
Suite 200
Mt Pleasant, SC 29464-6692
Mailing address
886 Tupelo Bay Dr
Mt Pleasant, SC 29464-8241
Phone (843) 881-9525
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3573 | SC | MD | Certified Registered Nurse Anesthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1417027152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "886 TUPELO BAY DR",
"city": "MT PLEASANT",
"state": "SC",
"postal_code": "294648241",
"telephone_number": "843-881-9525"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "152 CIVITAS ST",
"address_2": "SUITE 200",
"city": "MT PLEASANT",
"state": "SC",
"postal_code": "294646692",
"telephone_number": "843-388-0059",
"fax_number": "843-388-0019"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HORECKY",
"first_name": "ERIC",
"middle_name": "CONRAD",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "SC",
"license": "3573",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mt Pleasant, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.