NPIMap

Organization Active NPI

Earl B Hartzog DMD PA

  • General Practice Dentistry
  • Denmark, SC
National Provider Identifier
1588047724
Registry record updated Jul 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4591 Issued in SC
Legal business name
EARL B HARTZOG DMD PA
Practice address
5576 Carolina Hwy
Denmark, SC 29042-2238
Phone
(803) 793-3365
NPI assigned
Jul 7, 2015
Organization subpart
Yes
Parent organization
EARL B HARTZOG DMD PAAs reported in NPPES

Authorized official

NPPES NPI Registry
Name
Dr. Earl Barrett Hartzog, DMD
Title
President
Phone
(843) 560-1543

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

National Provider Directory
Tax ID family
Earl B Hartzog DMD PA8 organizations share this tax ID, including this one
Part of
Earl B Hartzog DMD PA

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5576 Carolina Hwy
Denmark, SC 29042
Phone (803) 793-3365

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 4591 SC Primary

Addresses

NPPES NPI Registry

Primary practice location

5576 Carolina Hwy
Denmark, SC 29042-2238

Mailing address

5576 Carolina Hwy
Denmark, SC 29042-2238
Phone (803) 793-3365

Other names 1

NPPES NPI Registry
  • Denmark Family Dental Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 19, 2015.

{
    "created_epoch": "1436227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437264000000",
    "number": "1588047724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5576 CAROLINA HWY",
            "city": "DENMARK",
            "state": "SC",
            "postal_code": "290422238",
            "telephone_number": "803-793-3365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5576 CAROLINA HWY",
            "city": "DENMARK",
            "state": "SC",
            "postal_code": "290422238",
            "telephone_number": "803-793-3365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EARL B HARTZOG DMD PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EARL B HARTZOG DMD PA",
        "enumeration_date": "2015-07-07",
        "last_updated": "2015-07-19",
        "status": "A",
        "authorized_official_last_name": "HARTZOG",
        "authorized_official_first_name": "EARL",
        "authorized_official_middle_name": "BARRETT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-560-1543",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "4591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Denmark Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Denmark, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 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.