Active NPI
John Joseph Sanders, D.D.S.
- Periodontics
- Charleston, SC
National Provider Identifier
1770633943
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 3235
- Practice address
- 171 Ashley Ave
Charleston, SC 29425-0001 - Phone
- (843) 792-3444
- Fax
- (843) 792-1376
- NPI assigned
- Jan 11, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 3235 | SC | Primary |
Addresses
Primary practice location
171 Ashley Ave
Charleston, SC 29425-0001
Mailing address
153 Brandywine Dr
Summerville, SC 29485-8019
Phone (843) 821-8357
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 |
|---|---|---|---|
| 3235 | SC | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1770633943",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "153 BRANDYWINE DR",
"city": "SUMMERVILLE",
"state": "SC",
"postal_code": "294858019",
"telephone_number": "843-821-8357"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "171 ASHLEY AVE",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294250001",
"telephone_number": "843-792-3444",
"fax_number": "843-792-1376"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDERS",
"first_name": "JOHN",
"middle_name": "JOSEPH",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "SC",
"license": "3235",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.