NPIMap

Organization Active NPI

Lucius F Wates DMD PA

  • General Practice Dentistry
  • Kingstree, SC
National Provider Identifier
1427178185
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1904 Issued in SC
Legal business name
LUCIUS F WATES DMD PA
Practice address
509 Thurgood Marshall Hwy
Kingstree, SC 29556-4107
Phone
(843) 355-9295
Fax
(843) 355-9296
NPI assigned
Mar 29, 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
Dr. Lucius Franklin Wates, DMDNPI 1245218593
Title
Pres. of Corporation
Phone
(843) 355-9295

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 1904 SC Primary

Addresses

Primary practice location

509 Thurgood Marshall Hwy
Kingstree, SC 29556-4107

Mailing address

509 Thurgood Marshall Hwy
Kingstree, SC 29556-4107
Phone (843) 355-9295

National Provider Directory

National Provider Directory

Locations

509 Thurgood Marshall Hwy
Kingstree, SC 29556
Phone (843) 355-9295

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": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1427178185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 THURGOOD MARSHALL HWY",
            "city": "KINGSTREE",
            "state": "SC",
            "postal_code": "295564107",
            "telephone_number": "843-355-9295",
            "fax_number": "843-355-9296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 THURGOOD MARSHALL HWY",
            "city": "KINGSTREE",
            "state": "SC",
            "postal_code": "295564107",
            "telephone_number": "843-355-9295",
            "fax_number": "843-355-9296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUCIUS F WATES DMD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WATES",
        "authorized_official_first_name": "LUCIUS",
        "authorized_official_middle_name": "FRANKLIN",
        "authorized_official_title_or_position": "PRES. OF CORPORATION",
        "authorized_official_telephone_number": "843-355-9295",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "1904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingstree, 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.