NPIMap

Organization Active NPI

Crystal Coast Dentistry

  • General Practice Dentistry
  • Cape Carteret, NC
National Provider Identifier
1689606733
Registry record updated Oct 10, 2011
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Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2366 Issued in NC
Legal business name
CRYSTAL COAST DENTISTRY
Practice address
202 WB McLean Dr.
Cape Carteret, NC 28584-8524
Phone
(252) 393-8168
Fax
(252) 393-2978
NPI assigned
Jul 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2011

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

Authorized official

Name
Dr. Jeffrey H. Scott, D.D.S.NPI 1871572479
Title
President
Phone
(252) 393-8168

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 2366 NC Primary

Addresses

Primary practice location

202 WB McLean Dr.
Cape Carteret, NC 28584-8524

Mailing address

202 WB McLean Dr.
Cape Carteret, NC 28584-8524
Phone (252) 393-8168

Other identifiers 3

IdentifierTypeStateIssuer
1680321OtherUNITED CONCORDIA
89016T6MedicaidNC
016T6OtherNCNORTH CAROLINA BCBS

Other names 1

  • Harold & Sholar, D.D.S., PA Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Crystal Coast Dentistry2 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.

Locations

202 Wb McLean Dr
Cape Carteret, NC 28584
Phone (252) 393-8168

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318204800000",
    "number": "1689606733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 WB MCLEAN DR.",
            "city": "CAPE CARTERET",
            "state": "NC",
            "postal_code": "285848524",
            "telephone_number": "252-393-8168",
            "fax_number": "252-393-2978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 WB MCLEAN DR.",
            "city": "CAPE CARTERET",
            "state": "NC",
            "postal_code": "285848524",
            "telephone_number": "252-393-8168",
            "fax_number": "252-393-2978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL COAST DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2011-10-10",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "252-393-8168",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "2366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1680321",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89016T6",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH CAROLINA BCBS",
            "identifier": "016T6",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Harold & Sholar, D.D.S., PA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Cape Carteret, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2011; 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.