George Pericles Stamatiades III, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DGD.9898 Issued in SC

Practice address

2830 Highway 52
Ste 360
Moncks Corner, SC 29461

Phone

(843) 990-4715

NPI assigned

Jun 27, 2019

Last updated

May 2, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Moncks Corner Dental Group, PC

  dba Moncks Corner Dental Group

  • General Practice Dentistry
  • Moncks Corner, SC
  • NPI 1902503832
  NPD
• Dr. Seongwon Choi PLLC.

  • Endodontics
  • Marysville, WA
  • NPI 1407774490
  NPD (past)
• Washington Dental Corporation, PC

  dba Smokey Point Smiles Dentistry

  • Dentist
  • Marysville, WA
  • NPI 1790141828
  NPD (past)

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

{
    "created_epoch": "1561593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682985600000",
    "number": "1841851029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2830 HIGHWAY 52",
            "address_2": "STE 360",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "29461",
            "telephone_number": "843-990-4715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2830 HIGHWAY 52",
            "address_2": "STE 360",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "29461",
            "telephone_number": "843-990-4715"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "199 State Highway 50",
            "address_purpose": "LOCATION",
            "city": "Pecos",
            "state": "NM",
            "postal_code": "87552",
            "country_code": "US",
            "telephone_number": "505-757-6482",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17103 28th Dr NE Ste 104",
            "address_purpose": "LOCATION",
            "city": "Marysville",
            "state": "WA",
            "postal_code": "982714830",
            "country_code": "US",
            "telephone_number": "360-208-0492",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1851 MacGregor Downs Rd",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "NC",
            "postal_code": "278345925",
            "country_code": "US",
            "telephone_number": "252-737-7504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAMATIADES",
        "first_name": "GEORGE",
        "middle_name": "PERICLES",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-27",
        "last_updated": "2023-05-02",
        "certification_date": "2023-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "DGD.9898",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE61194037",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Carolina Dept of Mental Health Accounting Office (Berkeley Community Mental Health Center)
• South Carolina Diagnostic Imaging, Inc. (Tricounty Radiology Moncks Corner)
• Shamoon Spells
• Vicky Sue Stahl, LPC
• Lydia Stallings
• Megan Eustace Starkweather, MSN, FNP-C
• Erin E Starnes
• Stars Mentoring Services
• State of South Carolina (SC Dhec)
• Bethany Steedly

• General Practice Dentistry in Moncks Corner, SC
• Providers in Moncks Corner, SC by specialty
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2023; 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.