Wade Family Dentistry LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

WADE FAMILY DENTISTRY LLC

Doing business as

Moore Family Dentistry

Practice address

1626 Harbor View Rd
Charleston, SC 29412-3201

Phone

(843) 795-4255

NPI assigned

Jun 5, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Mason Douglas Wade, DMDNPI 1669928305

Title

President

Phone

(843) 795-4255

Specialties & licenses 1

Addresses

Other names 1

• Moore Family Dentistry Doing business as

Locations

Practitioners 3

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

• Mason Wade, D.M.D.

  • General Practice Dentistry
  • Charleston, SC
  • NPI 1669928305
  NPD Authorized official
• Elizabeth Saunders Burgess, DMD

  • Dentist
  • Charleston, SC
  • NPI 1316371255
  NPD (past)
• James Durning Moore, DMD

  • General Practice Dentistry
  • Charleston, SC
  • NPI 1609936467
  NPD (past)

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

{
    "created_epoch": "1717545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717545600000",
    "number": "1710728563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 HARBOR VIEW RD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294123201",
            "telephone_number": "843-795-4255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1626 HARBOR VIEW RD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294123201",
            "telephone_number": "843-795-4255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WADE FAMILY DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-05",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A",
        "authorized_official_last_name": "WADE",
        "authorized_official_first_name": "MASON",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-795-4255",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Moore Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Anna Wachler-Harris, OTR/L
• Paul S Wachowiak, PH.D.
• Elizabeth Bunch Wachowicz, APRN
• Bryan Wacker, DO
• Robin Elaine Waddell, ANP
• Allison Marie Wade, PA-C
• Dianne Leblanc Wade, R.D.
• Donald F Wade, M.D.
• Graham Clarkson Wade, PT
• Jennifer Boyland Wade, D.D.S.

• Dental Clinic/Center in Charleston, SC
• Providers in Charleston, 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 Jun 5, 2024; 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.