SOUTH STRAND DENTAL ASSOCIATES INC NPI 1780735712

NPI Information

  • NPI: 1780735712
  • Provider Name: SOUTH STRAND DENTAL ASSOCIATES, INC
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Organization
  • CLIA Number: 42D2191145
  • Address: 1616 AZALEA DR
    SURFSIDE BEACH, SC
    ZIP 29575
  • Phone: (843) 238-5111

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NPI Details

SOUTH STRAND DENTAL ASSOCIATES, INC is a general practice dentist in Surfside Beach, SC. The provider is 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. SOUTH STRAND DENTAL ASSOCIATES, INC NPI is 1780735712. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

1616 AZALEA DR
SURFSIDE BEACH, SC
ZIP 29575-277
Phone: (843) 238-5111
Fax: (843) 238-2412

The provider's authorized official is Daniel W Miller .
The authorized official title is Dentist and has the following contact phone number (843) 238-5111.

The CLIA number assigned to this NPI record is 42D2191145 - ancillary testing site in health care center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/16/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral Practice2200SOUTH CAROLINANo
21223G0001XDentistGeneral Practice4045SOUTH CAROLINANo
31223G0001XDentistGeneral Practice2437SOUTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1ZA9758MEDICAIDSOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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