Active NPI
Brian G Jelinek, DMD
- Dentist
- Pawley's Island, SC
National Provider Identifier
1992818215
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 4664
- Practice address
- 38 Black Gum Rd
Unit G
Pawleys Island, SC 29585-6087 - Phone
- (843) 235-2719
- NPI assigned
- Aug 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 4664 | SC | Primary |
Addresses
Primary practice location
38 Black Gum Rd
Unit G
Pawleys Island, SC 29585-6087
Mailing address
38-G Black Gum Rd
Pawleys Island, SC 29585-6087
Phone (843) 235-2719
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
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.
-
- Dental Clinic/Center
- Pawley's Island, SC
- NPI 1558783530
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1386288000000",
"number": "1992818215",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "38-G BLACK GUM RD",
"city": "PAWLEYS ISLAND",
"state": "SC",
"postal_code": "295856087",
"telephone_number": "843-235-2719"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "38 BLACK GUM RD",
"address_2": "UNIT G",
"city": "PAWLEYS ISLAND",
"state": "SC",
"postal_code": "295856087",
"telephone_number": "843-235-2719"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JELINEK",
"first_name": "BRIAN",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-17",
"last_updated": "2013-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "SC",
"license": "4664",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pawley's Island, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.