Organization Active NPI

Piedmont Dental Center

  • Dentist
  • Spartanburg, SC
National Provider Identifier
1104929116
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
PIEDMONT DENTAL CENTER
Practice address
975 North Church Street
Spartanburg, SC 29303
Phone
(864) 582-4308
Fax
(864) 596-4492
NPI assigned
Sep 6, 2006
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
Mrs. Angie B Webb
Title
Asst Office Manager
Phone
(864) 582-4308

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

975 North Church Street
Spartanburg, SC 29303

Mailing address

975 North Church Street
Spartanburg, SC 29303
Phone (864) 582-4308

Other identifiers 1

IdentifierTypeStateIssuer
ZA9992MedicaidSC

Other names 1

  • Charleston Denture Center Columbia Denture Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Charleston Denture Center Columbia Denture Cent2 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.

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104929116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 NORTH CHURCH STREET",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "29303",
            "telephone_number": "864-582-4308",
            "fax_number": "864-596-4492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 NORTH CHURCH STREET",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "29303",
            "telephone_number": "864-582-4308",
            "fax_number": "864-596-4492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIEDMONT DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WEBB",
        "authorized_official_first_name": "ANGIE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "ASST OFFICE MANAGER",
        "authorized_official_telephone_number": "864-582-4308",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZA9992",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Charleston Denture Center Columbia Denture Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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.