Mackenzie Grace Long, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DGD.10514 Issued in SC

Practice address

129 Plantation North Blvd Ste D
Goose Creek, SC 29445-5776

Phone

(843) 410-4920

NPI assigned

Jun 9, 2023

Last updated

Jun 9, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1686268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686268800000",
    "number": "1982388146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 MEMORIAL DRIVE EXT STE 400",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296511850",
            "telephone_number": "864-282-1935",
            "fax_number": "864-751-6387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 PLANTATION NORTH BLVD STE D",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294455776",
            "telephone_number": "843-410-4920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "MACKENZIE",
        "middle_name": "GRACE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-09",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "DGD.10514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda W Lindsey
• Ryan Linton
• Lanny Franklin Littlejohn, M.D.
• Livefreefitness LLC
• Abigail Leanne Long, LMSW
• Marcio Limongi Lopes, RPH
• Ambar Roberly Lora Melenciano, PORPHY TECHNICIAN
• Nathan Lorei, MD
• Lowcountry Eye Care of Goose Creek
• Lowcountry Health Group LLC

• General Practice Dentistry in Goose Creek, SC
• Providers in Goose Creek, 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 Jun 9, 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.