Jason Wood, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

8440 Issued in SC

Practice address

624 Front St
Georgetown, SC 29440-3624

Phone

(843) 699-2500

NPI assigned

Apr 30, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Dec 3, 2019 through Dec 3, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• South Carolina Oral and Facial Surgery LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Georgetown, SC
  • NPI 1215671144
  NPD Authorized official
• Shelbourne & Associates Oral and Facial Surgery

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Charleston, SC
  • NPI 1730602319
  NPD (past)
• Upstate Oral and Maxillofacial Surgery, P.a.

  • Oral and Maxillofacial Surgery (Dentist)
  • Spartanburg, SC
  • NPI 1366577389
  NPD (past)

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

{
    "created_epoch": "1398816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659571200000",
    "number": "1699185538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 N GROVE MEDICAL PARK DR",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293034222",
            "telephone_number": "864-585-3318",
            "fax_number": "804-828-0056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 FRONT ST",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "294403624",
            "telephone_number": "843-699-2500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1250 E Marshall St",
            "address_2": "Box 980566",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "23298",
            "country_code": "US",
            "telephone_number": "804-628-6637",
            "fax_number": "804-828-0056",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOOD",
        "first_name": "JASON",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-30",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "SC",
            "license": "8440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Georgetown, SC
• Providers in Georgetown, SC by specialty
• Oral and Maxillofacial Surgery (Dentist) in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.