Individual provider Active NPI

Bryan Andrew Game, D.M.D., M.B.A.

  • General Practice Dentistry
  • Johns Island, SC
National Provider Identifier
1477831691
Registry record updated Nov 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8100 Issued in SC
Practice address
3750 Savannah Hwy
Ste. B
Johns Island, SC 29455-7909
Phone
(843) 203-5429
NPI assigned
Jul 22, 2011
Last updated
Nov 5, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 8100 SC Primary

Addresses

Primary practice location

3750 Savannah Hwy
Ste. B
Johns Island, SC 29455-7909

Mailing address

3750 Savannah Hwy
Ste. B
Johns Island, SC 29455-7909
Phone (843) 203-5429

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150625002402 SC Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 5890006258

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration

State licenses

LicenseStateTypeSpecialty
8100SCMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stono Dental Care, PA Dentist Past Accepting new patients
B. Andrew Game, DMD, LLC Dentist 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1311292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604534400000",
    "number": "1477831691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3750 SAVANNAH HWY",
            "address_2": "STE. B",
            "city": "JOHNS ISLAND",
            "state": "SC",
            "postal_code": "294557909",
            "telephone_number": "843-203-5429",
            "fax_number": "843-203-9036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3750 SAVANNAH HWY",
            "address_2": "STE. B",
            "city": "JOHNS ISLAND",
            "state": "SC",
            "postal_code": "294557909",
            "telephone_number": "843-203-5429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAME",
        "first_name": "BRYAN",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "D.M.D., M.B.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-22",
        "last_updated": "2020-11-05",
        "certification_date": "2020-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "8100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johns Island, SC

Sources for this page

Verify at the official NPI Registry.