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1724 STATE SUMMERVILLE PROFESSIONAL, LLC
NPI 1730847724
Dentist - General Practice in Summerville, SC

Active since December 07, 2021
1724 STATE RD UNIT 4D, SUMMERVILLE, SC 29486(843) 352-4454(843) 352-4875 Get Directions Write a Review

NPPES record last updated: December 7, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About 1724 State Summerville Professional, Llc NPPES

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

1724 STATE SUMMERVILLE PROFESSIONAL, LLC (NPI 1730847724), doing business as Cane Bay Family Dentistry, is a healthcare organization registered as a general practice in Summerville, South Carolina and active in the NPI registry since December 2021. The organization lists Peter Grumbos, Owner, as its authorized official.

NPPES Registry Identity

NPI1730847724
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business Name1724 STATE SUMMERVILLE PROFESSIONAL, LLC
Location Address1724 STATE RD UNIT 4DSummerville, SC 29486-2842
Mailing Address1724 State Rd Unit 4dSummerville, SC 29486-2842 · (843) 352-4454 · Fax (843) 352-4875
Phone(843) 352-4454
Fax(843) 352-4875
Organization SubpartNo
Authorized OfficialPeter GrumbosOwner · (843) 352-4454
Enumeration DateDecember 7, 2021
NPPES CertifiedNovember 29, 2021
✔ NPI 1730847724 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
1724 STATE RD UNIT 4D, Summerville, SC 29486
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Other Names 1

Doing Business AsCane Bay Family Dentistry

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of South Carolina.Insurance ›

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. VALERIE ELAINE MOONEY DMD
Dentist (General Practice)
1724 STATE RD UNIT 4D
SUMMERVILLE, SC 29486
Berkeley County (843) 352-4454
JESSICA DINH DMD
Dentist (General Practice)
1724 STATE RD UNIT 4D
SUMMERVILLE, SC 29486
Berkeley County (843) 376-3510
DARRELL HAYES
Dentist
1724 STATE RD UNIT 4D
SUMMERVILLE, SC 29486
Berkeley County (843) 376-4157
CANE BAY FAMILY DENTISTRY
Dentist (General Practice)
1724 STATE RD UNIT 4D
SUMMERVILLE, SC 29486
Berkeley County (843) 352-4454
DR. JILLIAN ELAINE BROUGHTON DMD
Dentist (General Practice)
1724 STATE RD UNIT 4D
SUMMERVILLE, SC 29486
Berkeley County (843) 352-4454

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 1724 State Summerville Professional, LLC's NPI number?

The NPI number for 1724 State Summerville Professional, LLC is 1730847724. It was assigned to this organization in the NPPES registry on December 7, 2021. The provider is doing business as Cane Bay Family Dentistry.

Where is 1724 State Summerville Professional, LLC located?

1724 State Summerville Professional, LLC is located at 1724 State Rd Unit 4D, Summerville, SC 29486. The listed phone number is (843) 352-4454.

What is 1724 State Summerville Professional, LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

What insurance does 1724 State Summerville Professional, LLC accept?

Health plans from BlueCross BlueShield of South Carolina list 1724 State Summerville Professional, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for 1724 State Summerville Professional, LLC was last updated on December 7, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.