Active NPI
Anastacia Lane, D.M.D
- Dentist
- Charleston, SC
National Provider Identifier
1871901256
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DGD 8423
- Practice address
- 700 Rutledge Ave
Charleston, SC 29403-4145 - Phone
- (843) 723-9582
- NPI assigned
- Jul 29, 2014
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | DGD 8423 | SC | Primary |
Addresses
Primary practice location
700 Rutledge Ave
Charleston, SC 29403-4145
Mailing address
1122 Lango Ave
Charleston, SC 29407-6430
Phone (917) 696-6491
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 |
|---|---|---|---|
| DGD 8423 | SC | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1406592000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406592000000",
"number": "1871901256",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1122 LANGO AVE",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294076430",
"telephone_number": "917-696-6491"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 RUTLEDGE AVE",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294034145",
"telephone_number": "843-723-9582"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANE",
"first_name": "ANASTACIA",
"credential": "D.M.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-07-29",
"last_updated": "2014-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "SC",
"license": "DGD 8423",
"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 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.