Allen Nathaniel Gustin, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

SC1532 Issued in SC

Practice address

113 Magnolia Street
Walterboro, SC 29488-0027

Phone

(843) 549-1215

NPI assigned

Aug 13, 2007

Last updated

Aug 13, 2007By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1186963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186963200000",
    "number": "1598957748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 402",
            "city": "WALTERBORO",
            "state": "SC",
            "postal_code": "294880027",
            "telephone_number": "843-549-1215",
            "fax_number": "843-549-1835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 MAGNOLIA STREET",
            "city": "WALTERBORO",
            "state": "SC",
            "postal_code": "294880027",
            "telephone_number": "843-549-1215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTIN",
        "first_name": "ALLEN",
        "middle_name": "NATHANIEL",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-13",
        "last_updated": "2007-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "SC1532",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "3851",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Walterboro, SC
• Providers in Walterboro, SC by specialty
• Dentist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2007; 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.