OrganizationActive
Lake Moultrie Dental LLC
NPI 1013482603 · Dental Clinic/Center · Moncks Corner, SC
Lake Moultrie Dental LLC is a Dental Clinic/Center organization in Moncks Corner, SC (NPI 1013482603).
Provider details
- NPI number
- 1013482603
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Brian Jaques, Owner/Dentist(843) 761-8720
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(67/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
205 Carolina Ave
Moncks Corner, SC 29461-3736
Phone: (843) 761-8720
Street-level locationGet directions
Mailing address
205 Carolina Ave
Moncks Corner, SC 29461-3736
Registry dates
- Enumerated
- 2018-10-10
- Last updated
- 2018-10-10
Frequently asked questions
- What is Lake Moultrie Dental LLC's NPI number?
- Lake Moultrie Dental LLC's National Provider Identifier (NPI) is 1013482603, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Lake Moultrie Dental LLC?
- Lake Moultrie Dental LLC is classified in the NPPES registry as Dental Clinic/Center (Ambulatory Health Care Facilities).
- Where is Lake Moultrie Dental LLC located?
- Lake Moultrie Dental LLC's practice location on file with NPPES is 205 Carolina Ave, Moncks Corner, SC 29461-3736.
- What is Lake Moultrie Dental LLC's phone number?
- The practice phone number listed in the NPPES registry for Lake Moultrie Dental LLC is (843) 761-8720.
- Who is the authorized official for Lake Moultrie Dental LLC?
- The authorized official listed on Lake Moultrie Dental LLC's NPPES record is Brian Jaques, Owner/Dentist. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Lake Moultrie Dental LLC's NPI active?
- Yes — Lake Moultrie Dental LLC's NPI (1013482603) is active in the NPPES registry as of the last update on 2018-10-10.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.