Individual provider Active NPI

John G McRoberts, DMD

  • General Practice Dentistry
  • Seneca, SC
National Provider Identifier
1952354045
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3718 Issued in SC
Practice address
875 Old Clemson Hwy
Seneca, SC 29672-8060
Phone
(864) 654-5733
Fax
(864) 654-1117
NPI assigned
May 18, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3718 SC Primary

Addresses

Primary practice location

875 Old Clemson Hwy
Seneca, SC 29672-8060

Mailing address

PO Box 349
Clemson, SC 29633-0349
Phone (864) 654-5733

Other identifiers 1

IdentifierTypeStateIssuer
ZX3718MedicaidSC

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150528002914 SC Order and Referring Only - Other (Non-Physician) 2961722194

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3718SCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
John G McRoberts DMD PA General Practice 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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1952354045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 349",
            "city": "CLEMSON",
            "state": "SC",
            "postal_code": "296330349",
            "telephone_number": "864-654-5733",
            "fax_number": "864-654-1117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 OLD CLEMSON HWY",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296728060",
            "telephone_number": "864-654-5733",
            "fax_number": "864-654-1117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCROBERTS",
        "first_name": "JOHN",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "3718",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZX3718",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seneca, SC

Sources for this page

Verify at the official NPI Registry.