NPIMap

Organization Active NPI

DS Dental, LLC

Doing business as Carolina Dental Care

  • Dentist
  • Loris, SC
National Provider Identifier
1811968159
Registry record updated Nov 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
DS DENTAL, LLC
Doing business as
Carolina Dental Care
Practice address
4004 Bayboro St.
Loris, SC 29569
Phone
(843) 756-2273
Fax
(843) 756-0242
NPI assigned
Jan 26, 2006
Last updated
Nov 16, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2018

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

Authorized official

Name
Lacey Jane Spiguzza
Title
Vice President
Phone
(765) 220-0620

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU Primary
Dental Clinic/Center 261QD0000X NU

Addresses

Primary practice location

4004 Bayboro St.
Loris, SC 29569

Mailing address

PO Box 369
Loris, SC 29569
Phone (843) 756-2273

Other identifiers 1

IdentifierTypeStateIssuer
ZA9575MedicaidSC

Other names 1

  • Carolina Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Carolina Dental Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4004 Bayboro St
Loris, SC 29569
Phone (843) 756-2273

Practitioners & affiliated clinicians

Practitioners 6

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": "1138233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542326400000",
    "number": "1811968159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 369",
            "city": "LORIS",
            "state": "SC",
            "postal_code": "29569",
            "telephone_number": "843-756-2273",
            "fax_number": "843-756-0242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4004 BAYBORO ST.",
            "city": "LORIS",
            "state": "SC",
            "postal_code": "29569",
            "telephone_number": "843-756-2273",
            "fax_number": "843-756-0242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DS DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-26",
        "last_updated": "2018-11-16",
        "status": "A",
        "authorized_official_last_name": "SPIGUZZA",
        "authorized_official_first_name": "LACEY",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "765-220-0620"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZA9575",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carolina Dental Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Carolina Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Loris, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2018; 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.