Samuel Newton Pratt Jr., D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30-2819 Issued in SC

Practice address

219 1St St
Moncks Corner, SC 29461-3726

Phone

(843) 761-8142

Fax

(843) 761-1690

NPI assigned

May 3, 2006

Last updated

Dec 9, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Family Dental Health Group LLC

  dba Family Dental Health of Moncks Corner

  • General Practice Dentistry
  • Moncks Corner, SC
  • NPI 1518710672
  NPD (past)

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386547200000",
    "number": "1568420859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 1ST ST",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294613726",
            "telephone_number": "843-761-8142",
            "fax_number": "843-761-1690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 1ST ST",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294613726",
            "telephone_number": "843-761-8142",
            "fax_number": "843-761-1690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRATT",
        "first_name": "SAMUEL",
        "middle_name": "NEWTON",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2013-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "30-2819",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Z28195",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carl R Potts, MD
• Kenyetta Vereen Powell, RN
• Suzanne E Powell, DMD
• Elaine K. Powers, RN
• PPCP Specialty Physicians, LLC
• Majesty Z Priester
• Brittany Shantel Prioleau, PHARMD
• Christine F Provost
• David B. Pruett
• Pruitthealth - Moncks Corner LLC (PruittHealth - Moncks Corner)

• General Practice Dentistry in Moncks Corner, SC
• Providers in Moncks Corner, 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 Dec 9, 2013; 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.