COASTAL CAROLINA ORAL MAXILLOFACIAL SURGERY
NPI 1194812339
Dentist - Oral and Maxillofacial Surgery in Myrtle Beach, SC

Q: What is Coastal Carolina Oral Maxillofacial Surgery's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Active since October 09, 2006

133 TOWNE CENTRE PKWY, MYRTLE BEACH, SC 29579(843) 448-1621(843) 626-2501 Get Directions Write a Review

NPPES record last updated: April 11, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 11, 2024, Feb 17, 2020 (2 updates tracked since 2020).

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About Coastal Carolina Oral Maxillofacial Surgery NPPES

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

COASTAL CAROLINA ORAL MAXILLOFACIAL SURGERY (NPI 1194812339) is a healthcare organization registered as an oral and maxillofacial surgery in Myrtle Beach, South Carolina and active in the NPI registry since October 2006. The organization lists Wilma Pond, Practice Administrator, as its authorized official.

NPPES Registry Identity

NPI1194812339

Entity TypeOrganization

Primary Taxonomy1223S0112X

Legal Business NameCOASTAL CAROLINA ORAL MAXILLOFACIAL SURGERY

Location Address133 TOWNE CENTRE PKWYMyrtle Beach, SC 29579

Mailing Address133 Towne Centre PkwyMyrtle Beach, SC 29579 · (843) 448-1621 · Fax (843) 626-2501

Phone(843) 448-1621

Fax(843) 626-2501

Organization SubpartNo

Authorized OfficialWilma PondPractice Administrator · (843) 448-1621

Enumeration DateOctober 9, 2006

Last NPPES UpdateApril 11, 20242 updates tracked since enumeration

NPPES CertifiedApril 11, 2024

✔ NPI 1194812339 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers

Taxonomy Code1223S0112X

Definition

An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

Also ListedClinic/Center · Oral and Maxillofacial SurgeryTaxonomy 261QS0112X

133 TOWNE CENTRE PKWY, Myrtle Beach, SC 29579

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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

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. EDWARD F. ECKERT JR. DDS

Dentist (Oral and Maxillofacial Surgery)