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General NPI Number Information
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NPI Number | 1861549990
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Entity Type | Individual
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Provider Name | FREDERICK LOOMIS CANBY DDS, MS
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Gender | Male
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 01/23/2026
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Provider Practice Location Address
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Address Line | 1149 SAVANNAH HWY STE 305
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City | CHARLESTON
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State | SC
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Zip | 29407-7819
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Country | US
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Telephone | 843-213-6881
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Fax |
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Provider Business Mailing Address
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Address Line | 4100 QUARLES CT
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City | ROCKINGHAM
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State | VA
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Zip | 22801-8797
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Country | US
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Telephone | 540-908-4846
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 10786
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 0401008477
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License Number State | VA
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