| NPI | 1366404659 |
|---|---|
| NPI Type | NPI-2 Organization |
| Status | Active |
| Enumeration Date | 2006-04-04 |
| Last Updated | 2023-08-14 |
| Authorized Official | Blake Guinn Practice Manager Phone: 8437973960 |
| Mailing Address | 9295 Medical Plaza Dr, B Charleston, SC 29406-9137 United States Phone: (843) 797-3960 📍 View Map |
| Primary Practice Address | 9295 Medical Plaza Dr, B Charleston, SC 29406-9137 United States Phone: (843) 797-3960 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| MEDICAID | SC | PA5761 | - |
| Other (non-Medicare) | SC | CK8300 | MEDICARE RAILROAD |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| Yes | 207N00000X – Dermatology | SC | 10773 |
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About NPI 1366404659
Trident Dermatology, Pa is an organization registered in the CMS NPPES NPI Registry with NPI number 1366404659. The primary specialty listed is Dermatology. The organization is located in Charleston, SC. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-04-04. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1366404659?
NPI 1366404659 belongs to Trident Dermatology, Pa, a Dermatology in Charleston, SC. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.
Is NPI 1366404659 active?
The current status of NPI 1366404659 in the NPPES registry is Active. The record was last updated on 2023-08-14.
What specialty is NPI 1366404659?
NPI 1366404659 is classified under the taxonomy Dermatology. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1366404659?
You can verify NPI 1366404659 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1366404659?
The primary practice address on file for NPI 1366404659 is 9295 Medical Plaza Dr, Charleston, SC 29406-9137. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1366404659 issued?
NPI 1366404659 was first issued (enumerated) on 2006-04-04. The NPPES record was last updated on 2023-08-14.
Practice Location Map
Trident Dermatology, Pa is located at 9295 Medical Plaza Dr, Charleston, SC. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Trident Dermatology, Pa. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1366404659. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Dermatology | 10773 | SC |