Individual provider Active NPI

Dustin Robert Plunkett, D.D.S.

  • Dentist
  • Johns Island, SC
National Provider Identifier
1730530874
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
9497 Issued in SC
Practice address
154 Gardners Cir
Johns Island, SC 29455-5467
Phone
(843) 768-8376
NPI assigned
Jun 30, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DEN1001737 DC
General Practice Dentistry 1223G0001X DEN1001737 DC
General Practice Dentistry 1223G0001X 0401415302 VA
Dentist 122300000X 9497 SC Primary

Addresses

Primary practice location

154 Gardners Cir
Johns Island, SC 29455-5467

Mailing address

1160 Varnum St NE Ste 6
Washington, DC 20017-2110
Phone (202) 269-7103

Other practice location 1

1160 Varnum St NE Ste 6
Washington, DC 20017-2110
Phone (202) 269-7103

Other practice location 2

1160 Varnum St NE Ste 6
Washington, DC 20017-2110
Phone (202) 854-7103

Other practice location 3

Department Of Veteran Affairs Medical Ctr
Dentistry
Hampton, VA 23667-0001
Phone (757) 722-9961 ext. 3530

Other practice location 4

1160 Varnum St NE Ste 6
Washington, DC 20017-2110
Phone (202) 854-7103

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

LicenseStateTypeSpecialty
DEN1001737DCMDDentist
9497SCMDDentist
0401415302VAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Kiawah Village Dentistry, PA CurrentSince Sep 13, 2020 Accepting new patients

Locations

154 Gardners Cir
Johns Island, SC 29455
Phone (843) 768-8376

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1467244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1730530874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1160 VARNUM ST NE STE 6",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200172110",
            "telephone_number": "202-269-7103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "154 GARDNERS CIR",
            "city": "JOHNS ISLAND",
            "state": "SC",
            "postal_code": "294555467",
            "telephone_number": "843-768-8376"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1160 Varnum St NE Ste 6",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200172110",
            "country_code": "US",
            "telephone_number": "202-269-7103",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1160 Varnum St NE Ste 6",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200172110",
            "country_code": "US",
            "telephone_number": "202-854-7103",
            "fax_number": "202-635-7145",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Department Of Veteran Affairs Medical Ctr",
            "address_2": "Dentistry",
            "address_purpose": "LOCATION",
            "city": "Hampton",
            "state": "VA",
            "postal_code": "236670001",
            "country_code": "US",
            "telephone_number": "757-722-9961 x3530",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1160 Varnum St NE Ste 6",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200172110",
            "country_code": "US",
            "telephone_number": "202-854-7103",
            "fax_number": "202-635-7145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PLUNKETT",
        "first_name": "DUSTIN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-30",
        "last_updated": "2022-07-21",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "DC",
            "license": "DEN1001737",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "DC",
            "license": "DEN1001737",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401415302",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "9497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johns Island, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.