Active NPI
Andrew Joseph Ponton, DMD
- General Practice Dentistry
- Goose Creek, SC
National Provider Identifier
1457734774
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 8745
- Practice address
- 122A S Goose Creek Blvd
Goose Creek, SC 29445-3136 - Phone
- (843) 764-3081
- NPI assigned
- Jul 6, 2015
- Sex
- Male
- Sole proprietor
- No
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 | 8745 | SC | Primary |
Addresses
Primary practice location
122A S Goose Creek Blvd
Goose Creek, SC 29445-3136
Mailing address
122A S Goose Creek Blvd
Goose Creek, SC 29445-3136
Phone (843) 764-3081
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 |
|---|---|---|---|
| 8745 | SC | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Goose Creek Family Dentistry LLC | General Practice | Past | Accepting new patients |
| Marshall V Miller | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- General Practice Dentistry
- Goose Creek, SC
- NPI 1508004268
-
- Dentist
- Goose Creek, SC
- NPI 1962670042
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436140800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1509667200000",
"number": "1457734774",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "122A S GOOSE CREEK BLVD",
"city": "GOOSE CREEK",
"state": "SC",
"postal_code": "294453136",
"telephone_number": "843-764-3081"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "122A S GOOSE CREEK BLVD",
"city": "GOOSE CREEK",
"state": "SC",
"postal_code": "294453136",
"telephone_number": "843-764-3081"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PONTON",
"first_name": "ANDREW",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-07-06",
"last_updated": "2017-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "SC",
"license": "8745",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Goose Creek, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.