NPIMap

Organization Active NPI

Lowcountry Dental Implant & Periodontics Center,LLC

  • Periodontics
  • Beaufort, SC
National Provider Identifier
1740326164
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
186 Issued in SC
Legal business name
LOWCOUNTRY DENTAL IMPLANT & PERIODONTICS CENTER,LLC
Practice address
1002 Bay St
Beaufort, SC 29902-5570
Phone
(843) 525-6264
Fax
(843) 522-8967
NPI assigned
Jan 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Charles H Kresch, DDSNPI 1619023934
Title
President
Phone
(843) 525-6264

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X 186 SC Primary

Addresses

Primary practice location

1002 Bay St
Beaufort, SC 29902-5570

Mailing address

1002 Bay St
Beaufort, SC 29902-5570
Phone (843) 525-6264

National Provider Directory

National Provider Directory

Locations

1002 Bay St
Beaufort, SC 29902
Phone (842) 525-6263

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740326164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 BAY ST",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299025570",
            "telephone_number": "843-525-6264",
            "fax_number": "843-522-8967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 BAY ST",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299025570",
            "telephone_number": "843-525-6264",
            "fax_number": "843-522-8967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOWCOUNTRY DENTAL IMPLANT & PERIODONTICS CENTER,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KRESCH",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-525-6264",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "SC",
            "license": "186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaufort, SC

Sources for this page

  • 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.