Individual provider Active NPI

Michael Eugene Piepenbring

  • Endodontics
  • Georgetown, SC
National Provider Identifier
1912188525
Registry record updated Nov 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
2679 Issued in SC
Practice address
1109 Memorial LN Ste B
Georgetown, SC 29440-3369
Phone
(843) 546-0173
NPI assigned
Nov 26, 2007
Last updated
Nov 26, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 26, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 2679 SC Primary

Addresses

Primary practice location

1109 Memorial LN Ste B
Georgetown, SC 29440-3369

Mailing address

1109 Memorial Lane Suite B
Georgetown, SC 29440-3311
Phone (843) 546-0173

Other identifiers 1

IdentifierTypeStateIssuer
Z26794MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160302001982 SC Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0244536167

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Michael E Piepenbring DMD Ms PC Endodontics Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1196035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196035200000",
    "number": "1912188525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 MEMORIAL LANE SUITE B",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "294403311",
            "telephone_number": "843-546-0173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 MEMORIAL LN STE B",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "294403369",
            "telephone_number": "843-546-0173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIEPENBRING",
        "first_name": "MICHAEL",
        "middle_name": "EUGENE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-26",
        "last_updated": "2007-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "SC",
            "license": "2679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Z26794",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, SC

Sources for this page

Verify at the official NPI Registry.