NPIMap

Organization Active NPI

Spartanburg Pediatric Dentistry

  • Pediatric Dentistry
  • Spartanburg, SC
National Provider Identifier
1083934202
Registry record updated Oct 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
SPARTANBURG PEDIATRIC DENTISTRY
Practice address
1575 Skylyn Dr
Spartanburg, SC 29307-1034
Phone
(864) 381-7731
NPI assigned
Jun 10, 2010
Last updated
Oct 19, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2010

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

Authorized official

Name
Dr. Charles Austin Birch, D.M.D.NPI 1124065107
Title
Owner
Phone
(864) 381-7731

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
Pediatric Dentistry 1223P0221X NU Primary

Addresses

Primary practice location

1575 Skylyn Dr
Spartanburg, SC 29307-1034

Mailing address

1575 Skylyn Dr
Spartanburg, SC 29307-1034
Phone (864) 381-7731

National Provider Directory

National Provider Directory

Locations

1575 Skylyn Dr
Spartanburg, SC 29307
Phone (864) 381-7731

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1276128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287446400000",
    "number": "1083934202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1575 SKYLYN DR",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293071034",
            "telephone_number": "864-381-7731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 SKYLYN DR",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293071034",
            "telephone_number": "864-381-7731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPARTANBURG PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-10",
        "last_updated": "2010-10-19",
        "status": "A",
        "authorized_official_last_name": "BIRCH",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "AUSTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "864-381-7731",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "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 Oct 19, 2010; 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.