DR. SUSAN H JAQUES DMD NPI 1568575363

NPI Information

  • NPI: 1568575363
  • Provider Name: DR. SUSAN H JAQUES, DMD
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 303 BURCH FORD RD
    HOLLY HILL, SC
    ZIP 29059
  • Phone: (803) 496-9012

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NPI Details

DR. Susan H Jaques, DMD is a general practice dentist in Holly Hill, 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. DR. Susan H Jaques, DMD NPI is 1568575363. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

303 BURCH FORD RD
HOLLY HILL, SC
ZIP 29059
Phone: (803) 496-9012
Fax: (803) 496-7054

The NPI 1568575363 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 8/16/2006 and was last updated on 7/8/2007.

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 Practice2538SOUTH 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
1992538MEDICAIDSOUTH 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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