Cda Dental PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6942 Issued in SC

Legal business name

CDA DENTAL PA

Doing business as

Lyman Family Dentistry

Practice address

301 Spartanburg Rd
Lyman, SC 29365-1746

Phone

(864) 439-1240

Fax

(864) 439-1241

NPI assigned

Apr 23, 2014

Last updated

Apr 23, 2014By 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

Dr. Christopher Derek Ayers, DMD

Title

President

Phone

(843) 406-3678

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Lyman Family Dentistry Doing business as

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

{
    "created_epoch": "1398211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398211200000",
    "number": "1043630437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 SPARTANBURG RD",
            "city": "LYMAN",
            "state": "SC",
            "postal_code": "293651746",
            "telephone_number": "864-439-1240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 SPARTANBURG RD",
            "city": "LYMAN",
            "state": "SC",
            "postal_code": "293651746",
            "telephone_number": "864-439-1240",
            "fax_number": "864-439-1241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CDA DENTAL PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-23",
        "last_updated": "2014-04-23",
        "status": "A",
        "authorized_official_last_name": "AYERS",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "DEREK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-406-3678",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "6942",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZX6942",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lyman Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Lyman, SC
• Providers in Lyman, 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 Apr 23, 2014; 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.