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LITTLE RIVER MEDICAL CENTER INC. NPI 1487835799


NPI Information

NPI: 1487835799
Provider Name: LITTLE RIVER MEDICAL CENTER, INC.
Classification: Dentist - 122300000X
Entity Type: Organization

CLIA Number: 42D2050133

Address:
4950 SOCASTEE BLVD
MYRTLE BEACH, SC
ZIP 29588
Phone: (843) 293-7800
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LITTLE RIVER MEDICAL CENTER, INC. is a dentist in Myrtle Beach, SC. The provider is a dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. LITTLE RIVER MEDICAL CENTER, INC. NPI is 1487835799. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4950 SOCASTEE BLVD
MYRTLE BEACH, SC
ZIP 29588-239
Phone: (843) 293-7800
Fax: (843) 293-6331

The provider's authorized official is Avangela Kay Criswell .
The authorized official title is Business Office Director and has the following contact phone number (843) 663-1013.

The CLIA number assigned to this NPI record is 42D2050133 - federally qualified health center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 11/15/2007 and was last updated on 3/29/2010.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1122300000XDentist4406SOUTH 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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1ZA9656MEDICAIDNORTH CAROLINA
2FQCO24MEDICAIDSOUTH 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: 4/28/2024

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