Robert Vincent Carimi Jr., D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7092 Issued in SC

Practice address

Tidelands Dental
1625 Glenns Bay Rd
Surfside, SC 29575

Phone

(845) 650-4500

NPI assigned

Jun 16, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1245110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1760619845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "TIDELANDS DENTAL",
            "address_2": "1625 GLENNS BAY RD",
            "city": "SURFSIDE",
            "state": "SC",
            "postal_code": "29575",
            "telephone_number": "845-650-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "TIDELANDS DENTAL",
            "address_2": "1625 GLENNS BAY RD",
            "city": "SURFSIDE",
            "state": "SC",
            "postal_code": "29575",
            "telephone_number": "845-650-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARIMI",
        "first_name": "ROBERT",
        "middle_name": "VINCENT",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-16",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "8969",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "7092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; 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.