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LEGACY PROSTHODONTICS LLC
NPI 1154208510
Dentist - Prosthodontics in Myrtle Beach, SC

Active since August 18, 2025
3017 NEWCASTLE LOOP, MYRTLE BEACH, SC 29588(843) 215-4343 Get Directions Write a Review

NPPES record last updated: August 18, 2025. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Legacy Prosthodontics Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LEGACY PROSTHODONTICS LLC (NPI 1154208510) is a healthcare organization registered as a prosthodontics in Myrtle Beach, South Carolina and active in the NPI registry since August 2025. The organization lists Charles Johnson, Owner-dentist, as its authorized official.

NPPES Registry Identity

NPI1154208510
Entity TypeOrganization
Primary Taxonomy1223P0700X
Legal Business NameLEGACY PROSTHODONTICS LLC
Location Address3017 NEWCASTLE LOOPMyrtle Beach, SC 29588-4502
Mailing Address3017 Newcastle LoopMyrtle Beach, SC 29588-4502 · (843) 215-4343
Phone(843) 215-4343
Organization SubpartNo
Authorized OfficialCharles JohnsonOwner-dentist · (843) 215-4343
Enumeration DateAugust 18, 2025
NPPES CertifiedAugust 18, 2025
✔ NPI 1154208510 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · ProsthodonticsDental Providers
Taxonomy Code1223P0700X
Definition
That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes.
3017 NEWCASTLE LOOP, Myrtle Beach, SC 29588
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Legacy Prosthodontics LLC's NPI number?

The NPI number for Legacy Prosthodontics LLC is 1154208510. It was assigned to this organization in the NPPES registry on August 18, 2025.

Where is Legacy Prosthodontics LLC located?

Legacy Prosthodontics LLC is located at 3017 Newcastle Loop, Myrtle Beach, SC 29588. The listed phone number is (843) 215-4343.

What is Legacy Prosthodontics LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Prosthodontics, with taxonomy code 1223P0700X.

When was this NPI record last updated?

The NPPES record for Legacy Prosthodontics LLC was last updated on August 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.