Individual provider Active NPI

Christopher J Latvis, DDS

  • General Practice Dentistry
  • Myrtle Beach, SC
National Provider Identifier
1508916602
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9367 Issued in CT
Practice address
1342 Farrow Pkwy
Myrtle Beach, SC 29577-1668
Phone
(843) 293-6700
NPI assigned
Jan 11, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

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 9367 CT Primary

Addresses

Primary practice location

1342 Farrow Pkwy
Myrtle Beach, SC 29577-1668

Mailing address

14 Maple St
Terryville, CT 06786
Phone (860) 583-3582

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

Practice roles

OrganizationSpecialtyStatusNew patients
Market Common Dentistry, PC General Practice PastSince Jun 23, 2024 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1508916602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 MAPLE ST",
            "city": "TERRYVILLE",
            "state": "CT",
            "postal_code": "06786",
            "telephone_number": "860-583-3582",
            "fax_number": "860-582-8654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1342 FARROW PKWY",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295771668",
            "telephone_number": "843-293-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATVIS",
        "first_name": "CHRISTOPHER",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "9367",
            "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 Jun 19, 2024; 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.