Village Family Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

90157 Issued in SC

Legal business name

VILLAGE FAMILY DENTAL

Practice address

3012 Newcastle Loop
Myrtle Beach, SC 29588-4501

Phone

(843) 215-2599

NPI assigned

Dec 3, 2007

Organization subpart

No

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

Authorized official

Name

Dr. John Michael Rearden Jr., DMDNPI 1871541896

Title

Owner/Dentist

Phone

(843) 215-2599

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John Michael Rearden, D.M.D.

  • Dentist
  • Myrtle Beach, SC
  • NPI 1871541896
  NPD (past) Authorized official
• Stephen F Tuttle, DDS

  • Dentist
  • Myrtle Beach, SC
  • NPI 1316973357
  NPD (past)
• Laura Emily Walters, DMD

  • Dentist
  • West Columbia, SC
  • NPI 1417401456
  NPD (past)

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

{
    "created_epoch": "1196640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196640000000",
    "number": "1952583924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3012 NEWCASTLE LOOP",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295884501",
            "telephone_number": "843-215-2599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3012 NEWCASTLE LOOP",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295884501",
            "telephone_number": "843-215-2599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-03",
        "last_updated": "2007-12-03",
        "status": "A",
        "authorized_official_last_name": "REARDEN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "843-215-2599",
        "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": "SC",
            "license": "90157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZA9719",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Veritas Executive Healthcare
• Veritas Healthcare Solutions, LLC
• Lydia Ivette Vidal-Cardozo, PAC
• Alissa Vidovich, OTR/L
• Anne Vierela, CNM
• Village Family Medical
• Mikhail Vinogradov, M.D.
• Jean M. Vinski, CRNA
• Naunihal Virk
• Visioin Care P.a.

• General Practice Dentistry in Myrtle Beach, SC
• Providers in Myrtle Beach, 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 Dec 3, 2007; 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.