Individual provider Active NPI

Robert Edward Iulo, DMD

  • General Practice Dentistry
  • Charleston, SC
National Provider Identifier
1649847435
Registry record updated Jun 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9892 Issued in SC
Practice address
2051 Sam Rittenberg Blvd Ste a
Charleston, SC 29407-4683
Phone
(843) 779-6844
NPI assigned
Jun 9, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 9892 SC Primary

Addresses

Primary practice location

2051 Sam Rittenberg Blvd Ste a
Charleston, SC 29407-4683

Mailing address

1716 N Woodmere Dr Apt 26
Charleston, SC 29407-2811
Phone (843) 422-9040

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
9892SCMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Jebediah S Christy DDS-Charleston PLLC General Practice PastSince Jun 15, 2021 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1623196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1649847435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1716 N WOODMERE DR APT 26",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294072811",
            "telephone_number": "843-422-9040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2051 SAM RITTENBERG BLVD STE A",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294074683",
            "telephone_number": "843-779-6844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IULO",
        "first_name": "ROBERT",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-09",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "9892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2021; 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.