Village Dentistry, PA

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

1688 Issued in SC

Legal business name

VILLAGE DENTISTRY, PA

Practice address

130 Gardners Cir
PMB#131
Johns Island, SC 29455-5467

Phone

(843) 768-8376

NPI assigned

Aug 29, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Robert W Haile, D.M.D.

Title

President

Phone

(843) 768-8376

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195516800000",
    "number": "1679767073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 GARDNERS CIR",
            "address_2": "PMB#131",
            "city": "JOHNS ISLAND",
            "state": "SC",
            "postal_code": "294555467",
            "telephone_number": "843-768-8376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 GARDNERS CIR",
            "address_2": "PMB#131",
            "city": "JOHNS ISLAND",
            "state": "SC",
            "postal_code": "294555467",
            "telephone_number": "843-768-8376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE DENTISTRY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-29",
        "last_updated": "2007-11-20",
        "status": "A",
        "authorized_official_last_name": "HAILE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-768-8376",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "SC",
            "license": "1688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Daniel Uderitz, M.D.
• Christopher Ursu, DC
• Furtuna Velaj
• Morgan Verhage
• Village Optical LLC
• Vincents Drug Store and Soda Fountain
• Vitality Chiropractic, LLC
• Wade Technologies LLC
• Michelle Whitney Wagner, BCBA

• Dental Clinic/Center in Johns Island, SC
• Providers in Johns Island, SC by specialty
• Dental Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.