NPIMap

Organization Active NPI

Jebediah S. Christy, DDS - Myrtle Beach PLLC

  • General Practice Dentistry
  • Myrtle Beach, SC
National Provider Identifier
1518336924
Registry record updated Oct 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8613 Issued in SC
Legal business name
JEBEDIAH S. CHRISTY, DDS - MYRTLE BEACH PLLC
Practice address
1209 N Retail CT
Myrtle Beach, SC 29577-9626
Phone
(843) 874-4060
Fax
(843) 443-6952
NPI assigned
Sep 16, 2015
Last updated
Oct 30, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2015

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

Authorized official

Name
Dr. Jebediah S Christy, DDS
Title
Owner
Phone
(315) 454-6000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 8613 SC Primary

Addresses

Primary practice location

1209 N Retail CT
Myrtle Beach, SC 29577-9626

Mailing address

PO Box 3189
Syracuse, NY 13220-3189
Phone (315) 454-6000

National Provider Directory

National Provider Directory

Locations

1209 N Retail Ct
Myrtle Beach, SC 29577
Phone (843) 357-0213

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1442361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446163200000",
    "number": "1518336924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3189",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132203189",
            "telephone_number": "315-454-6000",
            "fax_number": "315-410-5531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1209 N RETAIL CT",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295779626",
            "telephone_number": "843-874-4060",
            "fax_number": "843-443-6952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEBEDIAH S. CHRISTY, DDS - MYRTLE BEACH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-16",
        "last_updated": "2015-10-30",
        "status": "A",
        "authorized_official_last_name": "CHRISTY",
        "authorized_official_first_name": "JEBEDIAH",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-454-6000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "8613",
            "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 Oct 30, 2015; 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.