The Dental Retreat LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

THE DENTAL RETREAT LLC

Practice address

125 Botanical Cir
Travelers Rest, SC 29690-7112

Phone

(602) 502-4540

NPI assigned

Nov 25, 2024

Organization subpart

No

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

Authorized official

Name

Lauren Kelsey Boyd

Title

Owner

Phone

(602) 502-4540

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.

• William J Boyd Jr., DMD

  • General Practice Dentistry
  • Travelers Rest, SC
  • NPI 1679003156

  General Practice

  NPD

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

{
    "created_epoch": "1732492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736899200000",
    "number": "1033935994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 BOTANICAL CIR",
            "city": "TRAVELERS REST",
            "state": "SC",
            "postal_code": "296907112",
            "telephone_number": "602-502-4540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 BOTANICAL CIR",
            "city": "TRAVELERS REST",
            "state": "SC",
            "postal_code": "296907112",
            "telephone_number": "602-502-4540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE DENTAL RETREAT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-25",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A",
        "authorized_official_last_name": "BOYD",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_middle_name": "KELSEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-502-4540"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Table Rock Integrated Health and Wellness Practice, LLC.
• Susan Carol Tankersley, LMFT
• Nathan Lee Tate, MSW, LMSW, LCSWA
• Sybil Tezza, FNP
• The Dental Retreat at Mountain Park
• Indira Tikhonova
• Anthony B Tomkins, MSPT
• Gerald Drew Toney
• TR Talkers, LLC
• Trailhead Chiropractic

• All providers in Travelers Rest, SC
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; 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.