Organization Active NPI

Riccobene & Associates Ccci, DDS, PC

  • Oral and Maxillofacial Surgery (Dentist)
  • North Myrtle Beach, SC
National Provider Identifier
1891625265
Registry record updated May 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
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

Updated by the provider on May 19, 2026

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)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 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 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Brush and Floss North Myrtle Beach2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

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.

Verify at the official NPI Registry.