NPIMap

Organization Active NPI

Tooth Zone - Zona Dientes

  • Dentist
  • Greenville, SC
National Provider Identifier
1013220391
Registry record updated Jul 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
3490 Issued in SC
Legal business name
TOOTH ZONE - ZONA DIENTES
Practice address
103 Commons Way
Greenville, SC 29611
Phone
(864) 295-3086
Fax
(864) 295-3286
NPI assigned
Jul 15, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2010

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

Authorized official

Name
Dr. Harry Nick Bobotis, D.M.D.
Title
L.C.C.'S Member & President/General
Phone
(864) 329-5400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 3490 SC Primary

Addresses

Primary practice location

103 Commons Way
Greenville, SC 29611

Mailing address

103 Commons Way
Greenville, SC 29611
Phone (864) 295-3086

Other identifiers 1

IdentifierTypeStateIssuer
Z34909MedicaidSC

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1279152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279152000000",
    "number": "1013220391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 COMMONS WAY",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "29611",
            "telephone_number": "864-295-3086",
            "fax_number": "864-295-3286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 COMMONS WAY",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "29611",
            "telephone_number": "864-295-3086",
            "fax_number": "864-295-3286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOOTH ZONE - ZONA DIENTES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-15",
        "last_updated": "2010-07-15",
        "status": "A",
        "authorized_official_last_name": "BOBOTIS",
        "authorized_official_first_name": "HARRY",
        "authorized_official_middle_name": "NICK",
        "authorized_official_title_or_position": "L.C.C.'S MEMBER & PRESIDENT/GENERAL",
        "authorized_official_telephone_number": "864-329-5400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "SC",
            "license": "3490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Z34909",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2010; 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.