NPIMap

Organization Active NPI

Carolina Endodontics

  • Endodontics
  • Columbia, SC
National Provider Identifier
1508924705
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
Legal business name
CAROLINA ENDODONTICS
Practice address
130 Stonemark Lane
Columbia, SC 29210-3841
Phone
(803) 798-8476
Fax
(803) 798-6451
NPI assigned
Dec 4, 2006
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
Dr. Robert Jay Gohean, DMDNPI 1043370182
Title
President
Phone
(803) 798-8476

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
EndodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223E0200X Primary

Addresses

Primary practice location

130 Stonemark Lane
Columbia, SC 29210-3841

Mailing address

130 Stonemark Lane
Columbia, SC 29210-3841
Phone (803) 798-8476

National Provider Directory

National Provider Directory

Locations

130 Stonemark Ln
Columbia, SC 29210
Phone (803) 798-8476

Practitioners & affiliated clinicians

Practitioners 3

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": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508924705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 STONEMARK LANE",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292103841",
            "telephone_number": "803-798-8476",
            "fax_number": "803-798-6451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 STONEMARK LANE",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292103841",
            "telephone_number": "803-798-8476",
            "fax_number": "803-798-6451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA ENDODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GOHEAN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "803-798-8476",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, 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.