NPIMap

Organization Active NPI

Piedmont Orthodontic Associates PA

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Spartanburg, SC
National Provider Identifier
1083754865
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
SC1930 Issued in SC
Legal business name
PIEDMONT ORTHODONTIC ASSOCIATES PA
Practice address
319 North Pine Street
Suite 5
Spartanburg, SC 29302-1622
Phone
(864) 585-8709
Fax
(864) 585-8700
NPI assigned
Feb 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Ernest Jason Gardner Jr., DDS
Title
Owner Orthodontist
Phone
(864) 585-8709

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X 332 GA
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X SC1930 SC Primary

Addresses

Primary practice location

319 North Pine Street
Suite 5
Spartanburg, SC 29302-1622

Mailing address

319 North Pine Street
Suite 5
Spartanburg, SC 29302-1622
Phone (864) 585-8709

National Provider Directory

National Provider Directory

Locations

319 N Pine St
Ste 5
Spartanburg, SC 29302
Phone (864) 585-8709

Practitioners & affiliated clinicians

Practitioners 1

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": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083754865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 NORTH PINE STREET",
            "address_2": "SUITE 5",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293021622",
            "telephone_number": "864-585-8709",
            "fax_number": "864-585-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 NORTH PINE STREET",
            "address_2": "SUITE 5",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293021622",
            "telephone_number": "864-585-8709",
            "fax_number": "864-585-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIEDMONT ORTHODONTIC ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "ERNEST",
        "authorized_official_middle_name": "JASON",
        "authorized_official_title_or_position": "OWNER ORTHODONTIST",
        "authorized_official_telephone_number": "864-585-8709",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "GA",
            "license": "332",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "SC",
            "license": "SC1930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.