DENTAL PROFESSIONALS OF SOUTH CAROLINA, PC (NPI# 1053706747) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053706747 |
| Entity Type | Organization |
| Organization Name | DENTAL PROFESSIONALS OF SOUTH CAROLINA, PC |
| Other Organization Name | SMILES AT CAROLINA FOREST |
| Practice Address |
100 Debo Dr Unit 110 Myrtle Beach SC 29579-4921 |
| Practice Telephone | 8445144569 |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2015-03-31 |
| Authorized Official Name | HEATHER PRUEMER (CREDENTIALING) |
| Authorized Official Telephone | 2175408434 |
| Is Organization Subpart | Y |
| Parent Organization Name | DENTAL PROFESSIONALS OF SOUTH CAROLINA, PC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Smiles at Carolina Forest | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295195188 | Dental Professionals of South Carolina, PC | Dentist | 615 St. James Ave, Goose Creek, SC 29445 | 2016-03-04 |
| 1487013108 | Dental Professionals of South Carolina, PC | Dentist | 340 Harrison Bridge Rd, Suite D, Simpsonville, SC 29680-7133 | 2016-02-23 |
| 1609241033 | Dental Professionals of South Carolina, PC | Dentist | 9510 Dorchester Rd, Suite 400, North Charleston, SC 29485 | 2015-12-10 |
| 1871964015 | Dental Professionals of South Carolina, PC | Dentist | 1028 Edgewater Corp. Pkwy, Suite 101, Indian Land, SC 29707 | 2015-10-14 |
| 1972894251 | Dental Professionals of South Carolina, PC | Dentist | 2445 E Main St, Spartanburg, SC 29307-1415 | 2011-04-21 |
| Street Address |
100 DEBO DR UNIT 110 |
| City | MYRTLE BEACH |
| State | SC |
| Zip Code | 29579-4921 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083080337 | Jacob Shirk | Dentist | 100 Debo Dr Unit 110, Myrtle Beach, SC 29579-4921 | 2015-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598323198 | P & E Company | Counselor | 4105 Carolina Commercial Dr. Unit #2, Myrtle Beach, SC 29579 | 2019-05-30 |
| 1528624632 | Matthew Meehan | Nurse Practitioner | 4016 River Oaks Dr # 6511, Myrtle Beach, SC 29579 | 2019-05-14 |
| 1427518265 | Brian Donovan Doherty | Student in an Organized Health Care Education/Training Program | Grand Strand Medical Center 809 82nd Parkway, Gme Office, Myrtle Beach, SC 29579 | 2019-03-20 |
| 1508347931 | South Carolina Cvs Pharmacy LLC | Pharmacy | 578 International Dr, Myrtle Beach, SC 29579 | 2018-08-23 |
| 1497256176 | Orthosc LLC | Orthopaedic Surgery | 185 Fresh Dr Ste B, Myrtle Beach, SC 29579 | 2018-02-27 |
| 1740708981 | Dental Professional of South Carolina, P.C. | Dentist | 568 International Dr, Myrtle Beach, SC 29579 | 2017-09-08 |
| 1093232480 | Johnathan T Steppe | Dentist | 568 International Drive, Myrtle Beach, SC 29579 | 2017-08-25 |
| 1346638483 | Little River Medical Center, Inc | Clinic/Center | 4220 Carolina Exchange Blvd, Myrtle Beach, SC 29579 | 2014-12-23 |
| 1154726818 | Mina Gaid | Pharmacist | 1303 38th Avenue North, Myrtle Beach, SC 29579 | 2014-10-23 |
| 1528471364 | Paola Goyeneche | Counselor | 5015 Carolina Forest Blvd, Myrtle Beach, SC 29579 | 2014-06-10 |
| Find all providers in zip 29579 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891326617 | Southern Oak Dental, LLC | Dentist | 1017 Highway 501, Myrtle Beach, SC 29577-3820 | 2020-01-30 |
| 1104467224 | Dental Professional of South Carolina, P.C. | Dentist | 2749 Agnes Ln, Myrtle Beach, SC 29577-2029 | 2019-09-30 |
| 1669947511 | Forest Crossing Family Dental, LLC | Dentist | 4999 Carolina Forest Blvd Ste 14, Myrtle Beach, SC 29579-3588 | 2018-10-08 |
| 1740708981 | Dental Professional of South Carolina, P.C. | Dentist | 568 International Dr, Myrtle Beach, SC 29579 | 2017-09-08 |
| 1942667100 | Gamble Dentalsmart PC | Dentist | 1009 Highway 501, #70, Myrtle Beach, SC 29577-3820 | 2016-01-19 |
| 1740689967 | Kings Highway Dental Health Center, P.C. | Dentist | 1317 N Kings Hwy # 106, Myrtle Beach, SC 29577-3636 | 2014-08-14 |
| 1104243740 | Sparkle Dental Center Inc. | Dentist | 8848 Highway 17 Byp S, Myrtle Beach, SC 29588-7739 | 2014-03-20 |
| 1093075939 | Horry-georgetown Technical College | Dentist | 3500 Pampas Dr, Bldg. 1000, Myrtle Beach, SC 29577-5168 | 2012-05-25 |
| 1255663019 | Mark Conard | Dentist | 4382 Oleander Drive, Myrtle Beach, SC 29577 | 2010-02-04 |
| 1720223506 | Stephen M. Aiken, D.m.d., LLC | Dentist | 4932 Hwy 17 Byp S, Myrtle Beach, SC 29588-1619 | 2008-12-09 |
| Find all providers in MYRTLE BEACH | ||||
| City | MYRTLE BEACH |
| Zip Code | 29579 |
Please comment or provide details below to improve the information on DENTAL PROFESSIONALS OF SOUTH CAROLINA, PC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.