Provider Demographics
NPI:1023753878
Name:JOHN DURANT DMD LLC
Entity type:Organization
Organization Name:JOHN DURANT DMD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:A
Authorized Official - Last Name:DURANT
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:803-225-0145
Mailing Address - Street 1:809 LACHICOTTE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29492-6505
Mailing Address - Country:US
Mailing Address - Phone:803-225-0145
Mailing Address - Fax:
Practice Address - Street 1:7455 CROSS COUNTY RD STE 4
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29418-8470
Practice Address - Country:US
Practice Address - Phone:843-552-4771
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-04
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1902303852OtherINDIVIDUAL NPI