MEDICARE: CUSPIDS, INCORPORATED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	1223E0200X	Endodontics
2	1223G0001X	General Practice Dentistry
3	1223P0221X	Pediatric Dentistry
4	1223P0300X	Periodontics
5	1223P0700X	Prosthodontics
6	1223S0112X	Oral and Maxillofacial Surgery (Dentist)
7	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry
8	124Q00000X	Dental Hygienist
9	126800000X	Dental Assistant
10	126900000X	Dental Laboratory Technician
11	122300000X	Dentist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669537833
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CUSPIDS, INCORPORATED

Provider Business Mailing Address
First Line	:	3796 ASHLEY PHOSPHATE RD
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29418-8560
Country	:	US
Telephone Number	:	843-767-3300
Fax Number	:	843-207-1627

Provider Business Practice Location Address
First Line	:	3796 ASHLEY PHOSPHATE RD
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29418-8560
Country	:	US
Telephone Number	:	843-767-3300
Fax Number	:	843-207-1627

Authorized Official
Title or Position	:	OWNER
Name	:	DR. LOUIS A. HASSELL
Credential	:	D.D.S.
Telephone Number	:	843-767-3300

Provider Enumeration Date	:	12/27/2006
Last Update Date	:	09/11/2025

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