Children and Adult Dental LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

CHILDREN AND ADULT DENTAL LLC

Doing business as

Broad River Dentistry

Practice address

7210K Broad River Rd
Irmo, SC 29063-7973

Phone

(803) 407-2220

NPI assigned

Oct 22, 2018

Last updated

Oct 22, 2018By 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

Tonia Patterson

Title

Practice Administrator

Phone

(803) 600-7211

Specialties & licenses 1

Addresses

Other names 1

• Broad River Dentistry Doing business as

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

{
    "created_epoch": "1540166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540166400000",
    "number": "1053887653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7210K BROAD RIVER RD",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290637973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7210K BROAD RIVER RD",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290637973",
            "telephone_number": "803-407-2220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN AND ADULT DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-22",
        "last_updated": "2018-10-22",
        "status": "A",
        "authorized_official_last_name": "PATTERSON",
        "authorized_official_first_name": "TONIA",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "803-600-7211"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Broad River Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Center for Health Integration, Inc
• Johanna Ellen Chapman, CCC-SLP
• Robert Wayne Chapman Jr., R.PH.
• Clint Cheeseboro
• Kristen Claire Cherry, PT, DPT
• Childrens Dental Group of South Carolina
• Useline Christolin
• Micaela Anne Cisson
• Civic Care Soluctions LLC
• Kelly Clark

• Dental Clinic/Center in Irmo, SC
• Providers in Irmo, SC by specialty
• Dental Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2018; 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.