The Braces Place

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

302494 Issued in SC

Legal business name

THE BRACES PLACE

Practice address

502 N Lake Dr
Lexington, SC 29072-2806

Phone

(803) 359-4480

NPI assigned

Feb 17, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Robert F. Garrison, DMD

Title

Owner

Phone

(803) 661-8468

Specialties & licenses 1

Addresses

Tax ID family

The Braces Place2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• The Braces Place

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Columbia, SC
  • NPI 1033532262
  NPD tax ID

Locations

Practitioners 1

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

• Daniel Ryan Pennella, D.M.D., M.S.D.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Lexington, SC
  • NPI 1033402896
  NPD (past)

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

{
    "created_epoch": "1392595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392595200000",
    "number": "1083038780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 N LAKE DR",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290722806",
            "telephone_number": "803-359-4480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 N LAKE DR",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290722806",
            "telephone_number": "803-359-4480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BRACES PLACE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-17",
        "last_updated": "2014-02-17",
        "status": "A",
        "authorized_official_last_name": "GARRISON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-661-8468",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "SC",
            "license": "302494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leisha K Terry, PHARMD
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• Alfred Thomas Jr., LPC

• Exclusive Provider Organization in Lexington, SC
• Providers in Lexington, SC by specialty
• Exclusive Provider Organization in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 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.