NPI 1104743590 · live from the CMS NPI Registry
Dorchester Ortho LLC
Dentist, Orthodontics and Dentofacial Orthopedics in North Charleston, SC. National Provider Identifier 1104743590, active.
NPI record
| NPI | 1104743590 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dentist, Orthodontics and Dentofacial Orthopedics 1223X0400X |
| Practice location | 8626 Dorchester Rd Ste 102, North Charleston, SC 29420 |
| Practice phone | 843-261-2001 |
| Enumerated | July 6, 2026 |
| Last updated | July 6, 2026 |
| Authorized official | Jenni Tomlinson, Credentialing And Enrollment |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, Orthodontics and Dentofacial Orthopedics primary | 1223X0400X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.