City Dental Urgent Care

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

CITY DENTAL URGENT CARE

Practice address

105 N. Main St
West Columbia, SC 29169

Phone

(803) 764-3320

NPI assigned

Feb 15, 2019

Organization subpart

No

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

Authorized official

Name

Dr. George F Shull Jr., DMD

Title

Owner

Phone

(803) 764-3320

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1550188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550188800000",
    "number": "1902362890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 N. MAIN ST",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "29169",
            "telephone_number": "803-764-3320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 N. MAIN ST",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "29169",
            "telephone_number": "803-764-3320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY DENTAL URGENT CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-15",
        "last_updated": "2019-02-15",
        "status": "A",
        "authorized_official_last_name": "SHULL",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-764-3320",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTIST",
            "identifier": "1114379898",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL OFFICE",
            "identifier": "1962572701",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nabi Chowdhury, M.D.
• Christopher C. Newman DMD PA
• Deno Stavros Chrysostom, DMD
• Peter Ogbuu Chukwu, MD
• Brian Moonkyong Chung, M.D.
• Claire J Hyde MD PA
• Christopher Wayne Clark, AGNP
• James Marion Clark, PTA
• June Taylor Clark, APRN
• Meghan Clark

• General Practice Dentistry in West Columbia, SC
• Providers in West Columbia, SC by specialty
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2019; 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.