Active NPI
Stephen Ross Horton, D.M.D.
- General Practice Dentistry
- Moncks Corner, SC
National Provider Identifier
1730230046
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2500
- Practice address
- 421 Barony St
Suite 7
Moncks Corner, SC 29461-3145 - Phone
- (843) 761-7110
- Fax
- (843) 761-2913
- NPI assigned
- Jan 15, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2500 | SC | Primary |
| General Practice Dentistry | 1223G0001X | 2654 | SC |
Addresses
Primary practice location
421 Barony St
Suite 7
Moncks Corner, SC 29461-3145
Mailing address
421 Barony St
Suite 7
Moncks Corner, SC 29461-3145
Phone (843) 761-7110
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2500 | Medicaid | SC | |
| 2654 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2654 | SC | MD | Professional Counselor |
| 2500 | SC | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Berkeley Family Dentistry LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Dentist
- Moncks Corner, SC
- NPI 1679984942
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693958400000",
"number": "1730230046",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "421 BARONY ST",
"address_2": "SUITE 7",
"city": "MONCKS CORNER",
"state": "SC",
"postal_code": "294613145",
"telephone_number": "843-761-7110",
"fax_number": "843-761-2913"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "421 BARONY ST",
"address_2": "SUITE 7",
"city": "MONCKS CORNER",
"state": "SC",
"postal_code": "294613145",
"telephone_number": "843-761-7110",
"fax_number": "843-761-2913"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HORTON",
"first_name": "STEPHEN",
"middle_name": "ROSS",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-15",
"last_updated": "2023-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "SC",
"license": "2500",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "SC",
"license": "2654",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2500",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2654",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Moncks Corner, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.