NPIMap

Organization Active NPI

Dental Professionals of South Carolina, P.C.

Doing business as Crowfield Dental

  • General Practice Dentistry
  • Goose Creek, SC
National Provider Identifier
1982726600
Registry record updated Jun 21, 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
Crowfield Dental
Practice address
102 Springhall Dr
Goose Creek, SC 29445-5335
Phone
(843) 572-8009
Fax
(843) 377-0509
NPI assigned
Apr 4, 2007
Last updated
Jun 21, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2023

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

Authorized official

Name
Hannah Fish
Title
Credentialing Manager
Phone
(217) 540-5699

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X Primary

Addresses

Primary practice location

102 Springhall Dr
Goose Creek, SC 29445-5335

Mailing address

102 Springhall Dr
Goose Creek, SC 29445-5335
Phone (843) 572-8009

Other identifiers 3

IdentifierTypeStateIssuer
1393195OtherSCUNITED CONCORDIA
ZX3808MedicaidSC
ZA9634MedicaidSC

Other names 1

  • Crowfield Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dental Professional of SC74 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 13

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

View all 13

Locations

102 Springhall Dr
Goose Creek, SC 29445
Phone (843) 572-8009

Practitioners & affiliated clinicians

Practitioners 2

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": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687305600000",
    "number": "1982726600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 SPRINGHALL DR",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294455335",
            "telephone_number": "843-572-8009",
            "fax_number": "843-377-0509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 SPRINGHALL DR",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294455335",
            "telephone_number": "843-572-8009",
            "fax_number": "843-377-0509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL PROFESSIONALS OF SOUTH CAROLINA, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A",
        "authorized_official_last_name": "FISH",
        "authorized_official_first_name": "HANNAH",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "217-540-5699"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1393195",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZX3808",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZA9634",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crowfield Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Crowfield Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Goose Creek, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 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.