Active NPI
Riccobene & Associates Ccci, DDS, PC
- Oral and Maxillofacial Surgery (Dentist)
- North Myrtle Beach, SC
National Provider Identifier
1891625265
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- Legal business name
- RICCOBENE & ASSOCIATES CCCI, DDS, PC
- Practice address
- 900 Highway 17 S Ste C
North Myrtle Beach, SC 29582-1904 - Phone
- (843) 491-6021
- NPI assigned
- May 19, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michael Riccobene, DDS
- Title
- Ceo
- Phone
- (910) 853-6172
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | Primary |
Addresses
Primary practice location
900 Highway 17 S Ste C
North Myrtle Beach, SC 29582-1904
Mailing address
PO Box 749625
Atlanta, GA 30374-9625
Other names 1
- Edgewater Oral and Maxillofacial Surgery
National Provider Directory
National Provider Directory- Tax ID family
- Brush and Floss North Myrtle Beach
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Oral and Maxillofacial Surgery (Dentist)
- North Myrtle Beach, SC
- NPI 1205615341
Locations
900 Highway 17 S
Ste C
North Myrtle Beach, SC 29582
Phone (843) 491-6021
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1779148800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1779148800000",
"number": "1891625265",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 749625",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303749625"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 HIGHWAY 17 S STE C",
"city": "NORTH MYRTLE BEACH",
"state": "SC",
"postal_code": "295821904",
"telephone_number": "843-491-6021"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RICCOBENE & ASSOCIATES CCCI, DDS, PC",
"organizational_subpart": "NO",
"enumeration_date": "2026-05-19",
"last_updated": "2026-05-19",
"certification_date": "2026-05-19",
"status": "A",
"authorized_official_last_name": "RICCOBENE",
"authorized_official_first_name": "MICHAEL",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "910-853-6172",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Edgewater Oral and Maxillofacial Surgery",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in North Myrtle Beach, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.