Palmetto Health

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

PALMETTO HEALTH

Doing business as

Palmetto Health Dental Clinic

Practice address

10 Richland Medical Park Dr
Suite a
Columbia, SC 29203-6864

Phone

(803) 434-6567

Fax

(803) 434-6299

NPI assigned

Aug 8, 2016

Organization subpart

Yes

Parent organization

PALMETTO HEALTHAs reported in NPPES

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

Authorized official

Name

Darrell C Coven

Title

Director, Ambulatory Services Finan

Phone

(803) 296-7301

Specialties & licenses 1

Addresses

Other names 1

• Palmetto Health Dental Clinic Doing business as

Part of

Markowitz and Associates

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

{
    "created_epoch": "1470614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470614400000",
    "number": "1104370188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 402145",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303842145",
            "telephone_number": "803-296-7303",
            "fax_number": "803-296-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 RICHLAND MEDICAL PARK DR",
            "address_2": "SUITE A",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036864",
            "telephone_number": "803-434-6567",
            "fax_number": "803-434-6299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PALMETTO HEALTH",
        "enumeration_date": "2016-08-08",
        "last_updated": "2016-08-08",
        "status": "A",
        "authorized_official_last_name": "COVEN",
        "authorized_official_first_name": "DARRELL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DIRECTOR, AMBULATORY SERVICES FINAN",
        "authorized_official_telephone_number": "803-296-7301"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Palmetto Health Dental Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Palmetto Health
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• Oral and Maxillofacial Surgery (Dentist) in Columbia, SC
• Providers in Columbia, SC by specialty
• Oral and Maxillofacial Surgery (Dentist) in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2016; 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.