Wrmdsv III

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

WRMDSV III

Practice address

320 Broad St # 210
Charleston, SC 29401-1648

Phone

(843) 216-3484

NPI assigned

Jul 7, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Michael R Defee, DMD, PHD

Title

Dentist

Phone

(843) 216-3484

Specialties & licenses 1

Addresses

Other names 1

• MOD Aesthetics Doing business as

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1657152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657152000000",
    "number": "1720711641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 BROAD ST # 210",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294011648",
            "telephone_number": "843-216-3484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 BROAD ST # 210",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294011648",
            "telephone_number": "843-216-3484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WRMDSV III",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-07",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A",
        "authorized_official_last_name": "DEFEE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "843-216-3484",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD, PHD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@modaesthetics.com",
            "affiliation": "N",
            "endpointDescription": "Office Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "320 Broad St # 210",
            "city": "Charleston",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294011648",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "MOD Aesthetics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tara Michele Wright, MD
• Teresa Wright
• Tracy Ham Wright
• Tyra Wright, RBT
• William Arthur Wright, PA-C
• WSSH Powerback Rehabilitation Services, LLC
• Allison Wukovits
• Polly A Wurthmann, M.D
• Rachel Wyand, MD
• Wendy C Wyatt, RD,LD,CDM

• General Practice Dentistry in Charleston, SC
• Providers in Charleston, SC by specialty
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2022; 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.