Provider Demographics
NPI:1114085289
Name:ANDREWS, JAMES CHARLES (DMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:CHARLES
Last Name:ANDREWS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 OLD TROLLEY RD
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485-8278
Mailing Address - Country:US
Mailing Address - Phone:843-871-6351
Mailing Address - Fax:843-871-7558
Practice Address - Street 1:1720 OLD TROLLEY RD
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29485
Practice Address - Country:US
Practice Address - Phone:843-871-6351
Practice Address - Fax:843-871-7558
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2018-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18391223P0300X, 1223P0700X, 1223S0112X, 1223X0400X, 1223G0001X, 122300000X, 1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No1223P0300XDental ProvidersDentistPeriodontics
No1223P0700XDental ProvidersDentistProsthodontics
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No122300000XDental ProvidersDentist
No1223E0200XDental ProvidersDentistEndodontics