Vineyard Dental Group LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

VINEYARD DENTAL GROUP LLC

Practice address

463 Woodruff Rd
Greenville, SC 29607-3417

Phone

(864) 729-8661

Fax

(864) 568-5597

NPI assigned

Dec 19, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Keenan Webster Smith, DMDNPI 1043419088

Title

Owner

Phone

(864) 729-8661

Specialties & licenses 1

Addresses

Other names 1

• Keenan W. Smith, DMD Former legal business name

Locations

Practitioners 1

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

• Keenan Webster Smith, DMD

  • General Practice Dentistry
  • Greenville, SC
  • NPI 1043419088
  NPD Authorized official

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

{
    "created_epoch": "1702944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702944000000",
    "number": "1093583049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "463 WOODRUFF RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296073417",
            "telephone_number": "864-729-8661",
            "fax_number": "864-568-5597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "463 WOODRUFF RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296073417",
            "telephone_number": "864-729-8661",
            "fax_number": "864-568-5597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VINEYARD DENTAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-19",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KEENAN",
        "authorized_official_middle_name": "WEBSTER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "864-729-8661",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Keenan W. Smith, DMD",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Rebecca Anne Vilsaint, M.S. CCC-SLP
• Chelsea Vincke
• Nina S Vincoff, MD
• Christy Rae Vineberg, OTR/L
• Thomas William Vinegar
• Gladys Evelyn Vining
• Alexandra Vinson
• Alexis Vinson
• Gwen Vinson, RN,LPC,CACII
• Jessica Seabrook Vinson

• Dental Clinic/Center in Greenville, SC
• Providers in Greenville, 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 Dec 19, 2023; 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.