Renee G Shongo DMD PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2575 Issued in SC

Legal business name

RENEE G SHONGO DMD PA

Practice address

163 Medical Circle
West Columbia, SC 29169-3655

Phone

(803) 794-0905

Fax

(803) 794-5472

NPI assigned

Sep 5, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Renee G Shongo, DMD PA

Title

Dentist Practice Owner

Phone

(803) 794-0905

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359590400000",
    "number": "1902908338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 MEDICAL CIRCLE",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291693655",
            "telephone_number": "803-794-0905",
            "fax_number": "803-794-5472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 MEDICAL CIRCLE",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291693655",
            "telephone_number": "803-794-0905",
            "fax_number": "803-794-5472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEE G SHONGO DMD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-05",
        "last_updated": "2013-01-31",
        "status": "A",
        "authorized_official_last_name": "SHONGO",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "DENTIST PRACTICE OWNER",
        "authorized_official_telephone_number": "803-794-0905",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD PA"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "2575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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 Jan 31, 2013; 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.