NPIMap

Organization Active NPI

Charles E Corbett Jr, DMD PA

  • Dentist
  • Myrtle Beach, SC
National Provider Identifier
1629235205
Registry record updated May 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2786 Issued in SC
Legal business name
CHARLES E CORBETT JR, DMD PA
Practice address
308 79TH Ave N
Myrtle Beach, SC 29572-4304
Phone
(843) 449-7011
Fax
(843) 449-8383
NPI assigned
May 21, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2008

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

Authorized official

Name
Dr. Charles E Corbett Jr., DMDNPI 1275707713
Title
Owner
Phone
(843) 449-7011

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 2786 SC Primary

Addresses

Primary practice location

308 79TH Ave N
Myrtle Beach, SC 29572-4304

Mailing address

308 79TH Ave N
Myrtle Beach, SC 29572-4304
Phone (843) 449-7011

National Provider Directory

National Provider Directory
Tax ID family
Charles E Corbett Jr DMD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1211328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211328000000",
    "number": "1629235205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 79TH AVE N",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724304",
            "telephone_number": "843-449-7011",
            "fax_number": "843-449-8383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 79TH AVE N",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724304",
            "telephone_number": "843-449-7011",
            "fax_number": "843-449-8383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES E CORBETT JR, DMD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-21",
        "last_updated": "2008-05-21",
        "status": "A",
        "authorized_official_last_name": "CORBETT",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-449-7011",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "SC",
            "license": "2786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2008; 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.