NPIMap

Organization Active NPI

Sandhills Periodontics

  • Periodontics
  • Columbia, SC
National Provider Identifier
1053800623
Registry record updated Mar 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
3592 Issued in SC
Legal business name
SANDHILLS PERIODONTICS
Practice address
456 Clemson Rd
Columbia, SC 29229-7925
Phone
(803) 788-9715
Fax
(803) 788-9705
NPI assigned
May 9, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2019

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

Authorized official

Name
Dr. Sohee K ParkNPI 1700800497
Title
Owner
Phone
(803) 788-9715

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0300X 3592 SC Primary

Addresses

Primary practice location

456 Clemson Rd
Columbia, SC 29229-7925

Mailing address

456 Clemson Rd
Columbia, SC 29229-7925
Phone (803) 788-9715

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL office@sandhillsperio.com Direct

National Provider Directory

National Provider Directory

Locations

456 Clemson Rd
Columbia, SC 29229
Phone (803) 788-9715

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1525824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553644800000",
    "number": "1053800623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "456 CLEMSON RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292297925",
            "telephone_number": "803-788-9715",
            "fax_number": "803-788-9705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "456 CLEMSON RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292297925",
            "telephone_number": "803-788-9715",
            "fax_number": "803-788-9705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDHILLS PERIODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-09",
        "last_updated": "2019-03-27",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "SOHEE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-788-9715",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "SC",
            "license": "3592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "office@sandhillsperio.com",
            "affiliation": "N",
            "endpointDescription": "Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "456 Clemson Rd",
            "city": "Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "292297925",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Mar 27, 2019; 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.