Organization Active NPI

South Strand Dental Associates, Inc

  • General Practice Dentistry
  • Surfside Beach, SC
National Provider Identifier
1780735712
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2437 Issued in SC
Legal business name
SOUTH STRAND DENTAL ASSOCIATES, INC
Practice address
1616 Azalea Dr
Surfside Beach, SC 29575-5277
Phone
(843) 238-5111
Fax
(843) 238-2412
NPI assigned
Jan 16, 2007
Last updated
Aug 22, 2020By the provider in NPPES
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. Daniel W Miller II, DMDNPI 1164603429
Title
Dentist
Phone
(843) 238-5111

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2200 SC
General Practice Dentistry 1223G0001X 4045 SC
General Practice Dentistry 1223G0001X 2437 SC Primary

Addresses

Primary practice location

1616 Azalea Dr
Surfside Beach, SC 29575-5277

Mailing address

PO Box 15128
Surfside Beach, SC 29587-5128
Phone (843) 238-5111

Other identifiers 1

IdentifierTypeStateIssuer
ZA9758MedicaidSC

National Provider Directory

National Provider Directory

Locations

1616 Azalea Dr
Surfside Beach, SC 29575
Phone (843) 238-5111

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1780735712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15128",
            "city": "SURFSIDE BEACH",
            "state": "SC",
            "postal_code": "295875128",
            "telephone_number": "843-238-5111",
            "fax_number": "843-238-2412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 AZALEA DR",
            "city": "SURFSIDE BEACH",
            "state": "SC",
            "postal_code": "295755277",
            "telephone_number": "843-238-5111",
            "fax_number": "843-238-2412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH STRAND DENTAL ASSOCIATES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "843-238-5111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "2200",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "4045",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "2437",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZA9758",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Surfside Beach, 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.