NPIMap

Organization Active NPI

Dental Professionals of South Carolina, P.C.

Doing business as Waterway Dental Care

  • General Practice Dentistry
  • North Myrtle Beach, SC
National Provider Identifier
1952182149
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL PROFESSIONALS OF SOUTH CAROLINA, P.C.
Doing business as
Waterway Dental Care
Practice address
101 Highway 17 S
North Myrtle Beach, SC 29582-3117
Phone
(843) 492-5861
Fax
(843) 492-5829
NPI assigned
Oct 12, 2023
Last updated
Oct 12, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
DENTAL PROFESSIONALS OF SOUTH CAROLINA, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

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

Authorized official

Name
Belinda Huerta
Title
Credentialing Coordinator
Phone
(217) 540-2100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X Primary

Addresses

Primary practice location

101 Highway 17 S
North Myrtle Beach, SC 29582-3117

Mailing address

101 Highway 17 S
North Myrtle Beach, SC 29582-3117
Phone (843) 492-5861

Other names 1

  • Waterway Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dental Professionals of South Carolina74 organizations share this tax ID, including this one
Part of
Dental Professionals of South Carolina

Organizations with this tax ID in the same state 18

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 18

Locations

101 Highway 17 S
North Myrtle Beach, SC 29582
Phone (843) 492-5861

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1697068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697068800000",
    "number": "1952182149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 HIGHWAY 17 S",
            "city": "NORTH MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295823117",
            "telephone_number": "843-492-5861",
            "fax_number": "843-492-5829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 HIGHWAY 17 S",
            "city": "NORTH MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295823117",
            "telephone_number": "843-492-5861",
            "fax_number": "843-492-5829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL PROFESSIONALS OF SOUTH CAROLINA, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL PROFESSIONALS OF SOUTH CAROLINA, P.C.",
        "enumeration_date": "2023-10-12",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-11",
        "status": "A",
        "authorized_official_last_name": "HUERTA",
        "authorized_official_first_name": "BELINDA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-2100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Waterway Dental Care",
            "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 Oct 12, 2023; 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.