NPIMap

Organization Active NPI

Old Trolley Dental Assoc PA

  • General Practice Dentistry
  • Summerville, SC
National Provider Identifier
1689710758
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3872 Issued in SC
Legal business name
OLD TROLLEY DENTAL ASSOC PA
Practice address
600 Old Trolley Rd
Suite a
Summerville, SC 29485-5657
Phone
(843) 871-2971
Fax
(843) 871-7412
NPI assigned
Jan 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. William S. Kibler, DMDNPI 1629091376
Title
Dentist
Phone
(843) 871-2971

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 3872 SC Primary

Addresses

Primary practice location

600 Old Trolley Rd
Suite a
Summerville, SC 29485-5657

Mailing address

600 Old Trolley Rd
Suite a
Summerville, SC 29485-5657
Phone (843) 871-2971

National Provider Directory

National Provider Directory

Locations

600 Old Trolley Rd
Ste A
Summerville, SC 29485
Phone (843) 871-2971

Practitioners & affiliated clinicians

Practitioners 2

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": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689710758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 OLD TROLLEY RD",
            "address_2": "SUITE A",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294855657",
            "telephone_number": "843-871-2971",
            "fax_number": "843-871-7412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 OLD TROLLEY RD",
            "address_2": "SUITE A",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294855657",
            "telephone_number": "843-871-2971",
            "fax_number": "843-871-7412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD TROLLEY DENTAL ASSOC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KIBLER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "843-871-2971",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "3872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.