MYRTLE BEACH SMILES YOUTH DENTISTRY, LLC (NPI# 1568432391) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568432391 |
| Entity Type | Organization |
| Organization Name | MYRTLE BEACH SMILES YOUTH DENTISTRY, LLC |
| Practice Address |
1317 N Kings Hwy Suite 106 Myrtle Beach SC 29577-3636 |
| Mailing Address |
16 Arcade Unit 198747 Nashville TN 37219-1994 |
| Practice Telephone | 8436265437 |
| Practice Fax Number | 8436266308 |
| Mailing Telephone | 6157500343 |
| Mailing Fax Number | 6159861705 |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2014-07-09 |
| Authorized Official Name | MRS. JENELL STUMP (MANAGER, LICENSING & CREDENTIALING) |
| Authorized Official Telephone | 6157500343 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | ZA9485 | 05 |
| Street Address |
1317 N KINGS HWY SUITE 106 |
| City | MYRTLE BEACH |
| State | SC |
| Zip Code | 29577-3636 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346491461 | Jeremy S Bondurant | Dentist | 1317 N Kings Hwy, Suite 106, Myrtle Beach, SC 29577-3636 | 2008-10-07 |
| 1710015359 | Michael Alessi | Dentist | 1317 N Kings Hwy, Suite 106, Myrtle Beach, SC 29577-3636 | 2007-03-02 |
| 1467511444 | Craig John Hamilton | Dentist | 1317 N Kings Hwy, Suite 106, Myrtle Beach, SC 29577-3636 | 2006-12-06 |
| 1386657955 | Kevin Edward Hardy | Dentist | 1317 N Kings Hwy, Suite 106, Myrtle Beach, SC 29577-3636 | 2006-08-14 |
| 1235143900 | Michael Philip Meyer | Dentist | 1317 N Kings Hwy, Suite 106, Myrtle Beach, SC 29577-3636 | 2006-07-28 |
| 1487698239 | Elizabeth Tanner Goodwin | Dentist | 1317 N Kings Hwy, Suite 106, Myrtle Beach, SC 29577-3636 | 2006-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124536446 | Well Care Home Health of The Lowcountry | Home Health | 1039 44th Ave N Ste 101, Myrtle Beach, SC 29577 | 2018-01-22 |
| 1518470913 | Guillot Enterprises, LLC | Hearing Instrument Specialist | 1294 Professional Dr., Suite C, Myrtle, SC 29577 | 2017-11-08 |
| 1598288227 | Ryan Shepherd | Pharmacist | 1705 South Kings Highway, Myrtle Beach, SC 29577 | 2017-07-25 |
| 1184176554 | Shannon Long | Counselor | 1293 Professional Drive, Suite D Office 222, Myrtle Beach, SC 29577 | 2016-11-01 |
| 1265898191 | Coastal Carolina Infectious Disease, LLC | Internal Medicine | 1110 London St Ste 102, Myrtle Beach, SC 29577 | 2016-01-07 |
| 1548639933 | Susan Lang | Social Worker | 1273 Professional Dr., Suite A #104, Myrtle Beach, SC 29577 | 2015-09-16 |
| 1043600893 | Kenneth Edward Smith | Counselor | 1125 48th Avenue North, Myrtle Beach, SC 29577 | 2015-02-02 |
| 1902203615 | Sc Nursing Services LLC | Home Infusion | 1297 Professional Drive, Suite 201 C3, Myrtle Beach, SC 29577 | 2014-11-24 |
| 1881007946 | Intercoastal Endo, PC | Dentist | 4382 Oleander Dr, Myrtle Beach, SC 29577 | 2014-06-06 |
| 1891115739 | Julie Hite | Pharmacist | 540 Seaboard Street, Myrtle Beach, SC 29577 | 2014-04-18 |
| Find all providers in zip 29577 | ||||
| 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 |
| 1053706747 | Dental Professionals of South Carolina, PC | Dentist | 100 Debo Dr Unit 110, Myrtle Beach, SC 29579-4921 | 2015-03-31 |
| 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 |
| Find all providers in MYRTLE BEACH | ||||
| City | MYRTLE BEACH |
| Zip Code | 29577 |
Please comment or provide details below to improve the information on MYRTLE BEACH SMILES YOUTH DENTISTRY, LLC.
| 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.