Individual provider Active NPI

William Craig Draffin Jr., D.M.D.

  • General Practice Dentistry
  • Columbia, SC
National Provider Identifier
1043305881
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1986 Issued in SC
Practice address
1920 Bull St
#D
Columbia, SC 29201-2508
Phone
(803) 799-9517
Fax
(803) 799-9272
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 1986 SC Primary

Addresses

Primary practice location

1920 Bull St
#D
Columbia, SC 29201-2508

Mailing address

1920 Bull St
#D
Columbia, SC 29201-2508
Phone (803) 799-9517

Other identifiers 1

IdentifierTypeStateIssuer
Z19864MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1986SCMDClinical Neuropsychologist

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043305881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 BULL ST",
            "address_2": "#D",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012508",
            "telephone_number": "803-799-9517",
            "fax_number": "803-799-9272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 BULL ST",
            "address_2": "#D",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012508",
            "telephone_number": "803-799-9517",
            "fax_number": "803-799-9272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAFFIN",
        "first_name": "WILLIAM",
        "middle_name": "CRAIG",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "1986",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Z19864",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.