Lockwood Dental Asscociates, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1313 Issued in SC

Legal business name

LOCKWOOD DENTAL ASSCOCIATES, LLC

Practice address

14 Lockwood Drive
Ste a
Charleston, SC 29401

Phone

(843) 722-8500

Fax

(843) 720-8555

NPI assigned

Apr 18, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Craig Steven Modzelewski, DMD

Title

Owner

Phone

(843) 722-8500

Specialties & licenses 2

Addresses

Other identifiers 2

Practitioners 1

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.

• Everette Bowers Crotts, D.D.S.

  • General Practice Dentistry
  • Charleston, SC
  • NPI 1861591414
  NPD (past)

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1548486566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 LOCKWOOD DRIVE",
            "address_2": "STE A",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29401",
            "telephone_number": "843-722-8500",
            "fax_number": "843-720-8555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 LOCKWOOD DRIVE",
            "address_2": "STE A",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29401",
            "telephone_number": "843-722-8500",
            "fax_number": "843-720-8555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOCKWOOD DENTAL ASSCOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MODZELEWSKI",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-722-8500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "3892",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "1313",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZX3892",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Z13138",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Lobosky, MS CCC SLP
• Teal Dixon Lockard, RPH
• Madison Locke, RDN, LD
• Mark A Lockett, M.D.
• Albert Lockhart, MD
• Melissa E Loeffler, PA-C
• Aundrea Eason Loftley, M.D.
• Taylor Reet Jeansonne Lofton, MD
• Kimberly E Logan, LPC
• Mary Kathryn Scruggs Logan, FNP

• General Practice Dentistry in Charleston, SC
• Providers in Charleston, SC by specialty
• General Practice Dentistry in South Carolina

• 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.