Southern Pediatric Dentistry P.a.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

4046 Issued in SC

Legal business name

SOUTHERN PEDIATRIC DENTISTRY P.A.

Practice address

1515 N Fant St
Anderson, SC 29621-4707

Phone

(864) 844-9393

Fax

(864) 844-9395

NPI assigned

May 22, 2015

Last updated

May 22, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Katherine Bray Bryant, D.M.D.

Title

Pediatric Dentist

Phone

(864) 844-9393

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Douglas Collin Bryant, DMD

  • Pediatric Dentistry
  • Anderson, SC
  • NPI 1659710465
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1432252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432252800000",
    "number": "1003295031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 N FANT ST",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296214707",
            "telephone_number": "864-844-9393",
            "fax_number": "864-844-9395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 N FANT ST",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296214707",
            "telephone_number": "864-844-9393",
            "fax_number": "864-844-9395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN PEDIATRIC DENTISTRY P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-22",
        "last_updated": "2015-05-22",
        "status": "A",
        "authorized_official_last_name": "BRYANT",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_middle_name": "BRAY",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "864-844-9393",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "SC",
            "license": "4046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Carolina Dept of Mental Health Accounting Office (Anderson Oconee Pickens Mental Health)
• South Carolina Dept of Mental Health Accounting Office (Richard M Campbell Veterans Nursing Home)
• South Carolina Dept of Mental Health Accounting Office (Richard M Campbell Veterans Nursing Home)
• South Carolina Deptartment of Mental Health (Patrick B. Harris Psychiatric Hospital Pharmacy)
• Southern Home Care Services, Inc.
• Rodney George Southern, D.M.D.
• Southwest Carolina Treatment Center, LLC
• June Petryszn Souviron, M.D.
• Ethan Sowell
• Jondrea Speaks

• Pediatric Dentistry in Anderson, SC
• Providers in Anderson, SC by specialty
• Pediatric Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.