NPIMap

Organization Active NPI

Grand Strand Family and Esthetic Dentistry

  • General Practice Dentistry
  • Myrtle Beach, SC
National Provider Identifier
1467596403
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2503 Issued in SC
Legal business name
GRAND STRAND FAMILY AND ESTHETIC DENTISTRY
Practice address
3409 N Kings Hwy
Myrtle Beach, SC 29577-2929
Phone
(843) 448-6434
NPI assigned
Feb 15, 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
Walter MachowskiNPI 1184767105
Title
Pres
Phone
(843) 448-6434

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 2503 SC Primary

Addresses

Primary practice location

3409 N Kings Hwy
Myrtle Beach, SC 29577-2929

Mailing address

3409 N Kings Hwy
Myrtle Beach, SC 29577-2929
Phone (843) 448-6434

National Provider Directory

National Provider Directory
Tax ID family
Grand Strand Family and Esthetic Dentistry3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

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": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467596403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3409 N KINGS HWY",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295772929",
            "telephone_number": "843-448-6434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3409 N KINGS HWY",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295772929",
            "telephone_number": "843-448-6434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND STRAND FAMILY AND ESTHETIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MACHOWSKI",
        "authorized_official_first_name": "WALTER",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "843-448-6434"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "2503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, 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.