Legacy Prosthodontics LLC
NPI 1154208510ActiveOrganization· Dentist, Prosthodontics· Myrtle Beach, SC
Dentist, Prosthodontics in Myrtle Beach, South Carolina, registered in NPPES in August 2025. The authorized official on file is Charles Johnson, DMD, Owner-Dentist.
Overview
| NPI | 1154208510 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 18, 2025 |
| Last updated in NPPES | Aug 18, 2025 |
| Certified by provider | Aug 18, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, Prosthodontics Primary | 1223P0700X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Other Dentist, Prosthodontics providers in Myrtle Beach
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