NPIMap

Organization Active NPI

Summerville Smiles Dental Office, PC

  • General Practice Dentistry
  • Summerville, SC
National Provider Identifier
1972179307
Registry record updated May 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
SUMMERVILLE SMILES DENTAL OFFICE, PC
Practice address
1099 N Main St Ste 102
Summerville, SC 29483-7300
Phone
(843) 536-8577
NPI assigned
May 27, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2021

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

Authorized official

Name
Dr. Ali Shahrestani, DMD
Title
Owner Dentist
Phone
(843) 536-8577

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

1099 N Main St Ste 102
Summerville, SC 29483-7300

Mailing address

PO Box 920050
Dallas, TX 75392-0050
Phone (714) 845-8890

National Provider Directory

National Provider Directory

Locations

1099 N Main St
#102
Summerville, SC 29483
Phone (843) 536-8577

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1622073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622073600000",
    "number": "1972179307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753920050",
            "telephone_number": "714-845-8890",
            "fax_number": "303-952-0892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1099 N MAIN ST STE 102",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294837300",
            "telephone_number": "843-536-8577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMERVILLE SMILES DENTAL OFFICE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-27",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A",
        "authorized_official_last_name": "SHAHRESTANI",
        "authorized_official_first_name": "ALI",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "843-536-8577",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; 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.