Intercoastal Endo, PC

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

4617 Issued in SC

Legal business name

INTERCOASTAL ENDO, PC

Practice address

4382 Oleander Dr
Myrtle Beach, SC 29577

Phone

(843) 449-4900

Fax

(843) 449-1658

NPI assigned

Jun 6, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Mark C Conard, DMDNPI 1255663019

Title

President

Phone

(843) 449-4900

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark Conard, D.M.D.

  • Endodontics
  • Myrtle Beach, SC
  • NPI 1255663019
  NPD (past) Authorized official

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

{
    "created_epoch": "1402012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528329600000",
    "number": "1881007946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4382 OLEANDER DR",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "29577",
            "telephone_number": "843-449-4900",
            "fax_number": "843-449-1658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4382 OLEANDER DR",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "29577",
            "telephone_number": "843-449-4900",
            "fax_number": "843-449-1658"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4605 Oleander Dr",
            "address_2": "SUITE 2",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295775739",
            "country_code": "US",
            "telephone_number": "843-449-4900",
            "fax_number": "843-449-1658",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INTERCOASTAL ENDO, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-06",
        "last_updated": "2018-06-07",
        "status": "A",
        "authorized_official_last_name": "CONARD",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-449-4900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "SC",
            "license": "4617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Inmed Diagnostics Services of SC LLC
• Innovative Endodontics MB
• Luis D Insignares, MD
• Institute of Electrophysiology
• Institute of Electrophysiology
• Haylee Intiso-Leno, AGNP-C
• Jessica Leigh Ionno, NP
• John Edward Iseman, DDS
• James Michael Isernia, M.D.
• Marie Isom, EDD, LPC

• Endodontics in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Endodontics in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 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.