Grand Strand Pediatric Dentistry

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

3125SC Issued in SC

Legal business name

GRAND STRAND PEDIATRIC DENTISTRY

Practice address

3112 Dick Pond Road
Myrtle Beach, SC 29588-4833

Phone

(843) 294-5437

Fax

(843) 294-5440

NPI assigned

May 14, 2007

Organization subpart

Yes

Parent organization

GRAND STRAND PEDIATRIC DENTISTRYAs reported in NPPES

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

Authorized official

Name

Dr. Winona M Newman, DMDNPI 1699828681

Title

Owner

Phone

(843) 294-5437

Specialties & licenses 2

Addresses

Other identifiers 1

Part of

Grand Strand Pediatric Dentistry

Locations

Practitioners 1

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

• Winona Mae Newman, DMD

  • Dentist
  • Myrtle Beach, SC
  • NPI 1699828681
  NPD (past) Authorized official

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267574400000",
    "number": "1881800480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3112 DICK POND ROAD",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295884833",
            "telephone_number": "843-294-5437",
            "fax_number": "843-294-5440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3112 DICK POND ROAD",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295884833",
            "telephone_number": "843-294-5437",
            "fax_number": "843-294-5440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND STRAND PEDIATRIC DENTISTRY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GRAND STRAND PEDIATRIC DENTISTRY",
        "enumeration_date": "2007-05-14",
        "last_updated": "2010-03-03",
        "status": "A",
        "authorized_official_last_name": "NEWMAN",
        "authorized_official_first_name": "WINONA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-294-5437",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "SC",
            "license": "3125",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "SC",
            "license": "3125SC",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZA9590",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Grand Strand Family and Esthetic Dentistry
• Grand Strand Gynecology
• Grand Strand Healthcare, Inc.
• Grand Strand Internal Medicine PC
• Grand Strand Mobile Wound Care
• Grand Strand Pediatrics & Adolescent Medicine, P.a.
• Grand Strand Plastic & Reconstructive Surgery Center PA
• Grand Strand Psychological Services, PA
• Grand Strand Regional Medical Center, LLC
• Grand Strand Regional Medical Center, LLC

• Pediatric Dentistry in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Pediatric Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2010; 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.