Seaside Surgical, Inc.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

2222 Issued in SC

Legal business name

SEASIDE SURGICAL, INC.

Practice address

9356C Highway 17 Byp
Murrells Inlet, SC 29576-9328

Phone

(843) 492-4090

Fax

(843) 215-0579

NPI assigned

Dec 28, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Corneliud Jonathan Beck Jr., DDS

Title

Owner

Phone

(843) 492-4090

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720144314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9256C HIGHWAY 17 BYPASS",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "29576",
            "telephone_number": "843-492-4090",
            "fax_number": "843-215-0579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9356C HIGHWAY 17 BYP",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "295769328",
            "telephone_number": "843-492-4090",
            "fax_number": "843-215-0579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEASIDE SURGICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BECK",
        "authorized_official_first_name": "CORNELIUD",
        "authorized_official_middle_name": "JONATHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-492-4090",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "SC",
            "license": "2222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Seaside Anesthesia Consultants
• Seaside Dermatology PA
• Seaside Eye Associates South LLC
• Seaside Oral & Maxillofacial Surgery Inc
• Seaside Pediatric Dental Associates
• Don Edward Sessions Jr.
• Kelli Shaver
• Ashley Ericksen Shaw, APRN
• Ashley Marlynne Sheffield, PTA
• Hubert Coleman Shelley, PHARM D

• Dental Clinic/Center in Murrells Inlet, SC
• Providers in Murrells Inlet, 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 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.