SFD Mt. Pleasant LLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

SFD MT. PLEASANT LLC

Practice address

3102 N Highway 17
Mount Pleasant, SC 29466-6925

Phone

(843) 871-0842

NPI assigned

Oct 25, 2019

Organization subpart

Yes

Parent organization

A. FREDERICK SOLOMON DMD P.A.As reported in NPPES

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

Authorized official

Name

Angela E Bazzle

Title

Operations Manager

Phone

(843) 871-0842

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Part of

A Frederick Solomon DMD PA

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• A. Frederick Solomon DMD P.a.

  • Dentist
  • Summerville, SC
  • NPI 1063579829
  NPPES parent name

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

{
    "created_epoch": "1571961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612396800000",
    "number": "1457994196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1971 N MAIN ST",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294867890",
            "telephone_number": "843-871-0842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3102 N HIGHWAY 17",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294666925",
            "telephone_number": "843-871-0842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SFD MT. PLEASANT LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "A. FREDERICK SOLOMON DMD P.A.",
        "enumeration_date": "2019-10-25",
        "last_updated": "2021-02-04",
        "certification_date": "2021-02-04",
        "status": "A",
        "authorized_official_last_name": "BAZZLE",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "843-871-0842"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZX8766",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "MountPleasant",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3102 N Highway 17",
            "city": "Mount Pleasant",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294666925",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Serenity Internal Medicine, LLC
• Lyndsey Serino, M.A., CCC-SLP
• Nicole Service, LISW-CP
• Sewee Dental Care LLC
• Hope Seyler, PT, DPT, ATC
• Nicholas C. Shaheen, MD
• Briana Shakir-Lesesne
• Ritu Sharma, RPT
• Elizabeth D Sharpe, M.D.
• Ellen Shaw, M.ED. ,LPC

• Oral and Maxillofacial Surgery (Dentist) in Mount Pleasant, SC
• Providers in Mount Pleasant, SC by specialty
• Oral and Maxillofacial Surgery (Dentist) in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2021; 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.