Seabreeze Orthodontics

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

SEABREEZE ORTHODONTICS

Practice address

107 Surgeons Dr
Myrtle Beach, SC 29579-5198

Phone

(843) 903-3300

NPI assigned

Dec 2, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Juan Faja Fernandez, DMD

Title

Orthodontist/Business Owner

Phone

(843) 903-3300

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1669939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669939200000",
    "number": "1821708595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 SURGEONS DR",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295795198",
            "telephone_number": "843-903-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 SURGEONS DR",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295795198",
            "telephone_number": "843-903-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEABREEZE ORTHODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-02",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A",
        "authorized_official_last_name": "FAJA FERNANDEZ",
        "authorized_official_first_name": "JUAN",
        "authorized_official_title_or_position": "ORTHODONTIST/BUSINESS OWNER",
        "authorized_official_telephone_number": "843-903-3300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Orthodontics and Dentofacial Orthopedics Dentistry in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2022; 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.