Justin Stanford, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DGD.9903 Issued in SC

Practice address

121 N Pine St
Batesburg Leesville, SC 29006-1974

Phone

(803) 532-6146

NPI assigned

Jun 9, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Leishman Dental

  • General Practice Dentistry
  • Batesburg Leesville, SC
  • NPI 1518564046

  General Practice

  NPD

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

{
    "created_epoch": "1623196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662854400000",
    "number": "1003483827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 N PINE ST",
            "city": "BATESBURG",
            "state": "SC",
            "postal_code": "290061974",
            "telephone_number": "803-532-6146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 N PINE ST",
            "city": "BATESBURG LEESVILLE",
            "state": "SC",
            "postal_code": "290061974",
            "telephone_number": "803-532-6146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANFORD",
        "first_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-09",
        "last_updated": "2022-09-11",
        "certification_date": "2021-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "DGD.9903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suzanne L Schwab, MD
• Amanda Heller Scott, PA-C
• Ashton Shealy, MSN, RN, CPNP
• Raymond Ralph Skinner, M.D.
• Southern Roots Chiropractic
• Virginia W Summerall, FNP-BC
• Scott A Thomas, MS, ATC, SCAT, CSCS
• Geng Tian, DMD
• Carrie Rose Trotter, NP
• Wal-Mart Stores East, LP

• General Practice Dentistry in Batesburg Leesville, SC
• Providers in Batesburg Leesville, SC by specialty
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2022; 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.