Individual provider Active NPI

Robert Bryan Whitten, D.M.D., M.S.D.

  • Endodontics
  • Conway, SC
National Provider Identifier
1588911861
Registry record updated Jan 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
839 ENDO Issued in SC
Practice address
701 Main St
Conway, SC 29526-4341
Phone
(843) 488-3636
NPI assigned
Aug 6, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 8076 SC
Endodontics 1223E0200X 839 ENDO SC Primary

Addresses

Primary practice location

701 Main St
Conway, SC 29526-4341

Mailing address

4052 Harleston Green LN
Mount Pleasant, SC 29466-6953
Phone (843) 318-2926

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
839 ENDOSCMDEndodontist

NPI Registry JSON

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

{
    "created_epoch": "1344211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514851200000",
    "number": "1588911861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4052 HARLESTON GREEN LN",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294666953",
            "telephone_number": "843-318-2926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 MAIN ST",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295264341",
            "telephone_number": "843-488-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITTEN",
        "first_name": "ROBERT",
        "middle_name": "BRYAN",
        "name_prefix": "Dr.",
        "credential": "D.M.D., M.S.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-06",
        "last_updated": "2018-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "8076",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "SC",
            "license": "839 ENDO",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2018; 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.