NPIMap

Organization Active NPI

Mouth Carolina Dentistry, PA

  • General Practice Dentistry
  • Charleston, SC
National Provider Identifier
1740568765
Registry record updated Apr 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4643 Issued in SC
Legal business name
MOUTH CAROLINA DENTISTRY, PA
Practice address
3 Gamecock Ave
Suite 302
Charleston, SC 29407-3378
Phone
(843) 556-4798
Fax
(843) 556-4798
NPI assigned
Jul 25, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2013

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

Authorized official

Name
Mr. Andrew William Greenberg, DMDNPI 1891925434
Title
President
Phone
(843) 260-4592

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 4643 SC Primary

Addresses

Primary practice location

3 Gamecock Ave
Suite 302
Charleston, SC 29407-3378

Mailing address

3 Gamecock Ave
Suite 302
Charleston, SC 29407-3378
Phone (843) 556-4798

National Provider Directory

National Provider Directory

Locations

3 Gamecock Ave
Ste 302
Charleston, SC 29407
Phone (843) 556-4798

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": "1311552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367193600000",
    "number": "1740568765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 GAMECOCK AVE",
            "address_2": "SUITE 302",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294073378",
            "telephone_number": "843-556-4798",
            "fax_number": "843-556-4798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 GAMECOCK AVE",
            "address_2": "SUITE 302",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294073378",
            "telephone_number": "843-556-4798",
            "fax_number": "843-556-4798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUTH CAROLINA DENTISTRY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-25",
        "last_updated": "2013-04-29",
        "status": "A",
        "authorized_official_last_name": "GREENBERG",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-260-4592",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "4643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2013; 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.