Active NPI
Dental Wellness Center Eb5 VI LLC
Doing business as Angel Dental Manning
- General Practice Dentistry
- Manning, SC
National Provider Identifier
1114551058
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- Legal business name
- DENTAL WELLNESS CENTER EB5 VI LLC
- Doing business as
- Angel Dental Manning
- Practice address
- 1988 Paxville Hwy
Manning, SC 29102-6432 - Phone
- (803) 433-4600
- Fax
- (803) 433-4601
- NPI assigned
- Mar 1, 2020
- Last updated
- Mar 1, 2020
- Organization subpart
- Yes
- Parent organization
- DENTAL WELLNESS CENTER EB5 VI LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Shari Matthews
- Title
- Director of Operations
- Phone
- (843) 599-9590
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | NU | Primary |
Addresses
Primary practice location
1988 Paxville Hwy
Manning, SC 29102-6432
Mailing address
749 Stockbridge Dr
Fort Mill, SC 29708-7200
Phone (803) 335-5585
Other names 2
- Angel Dental Manning
- Dental Home EB5 VI, LLC
National Provider Directory
National Provider Directory- Tax ID family
- Dental Wellness Center Eb5 Investment VI LLC
- Part of
- Dental Wellness Center Eb5 Investment VI LLC
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Angel Dental Irmo
- General Practice Dentistry
- Columbia, SC
- NPI 1336787811
-
dba Angel Dental Fort Mill
- General Practice Dentistry
- Fort Mill, SC
- NPI 1639717010
Locations
749 Stockbridge Dr
Fort Mill, SC 29708
Phone (704) 960-2492
1988 Paxville Hwy
Manning, SC 29102
Phone (803) 433-4600
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1583020800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1583020800000",
"number": "1114551058",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "749 STOCKBRIDGE DR",
"city": "FORT MILL",
"state": "SC",
"postal_code": "297087200",
"telephone_number": "803-335-5585",
"fax_number": "803-335-0515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1988 PAXVILLE HWY",
"city": "MANNING",
"state": "SC",
"postal_code": "291026432",
"telephone_number": "803-433-4600",
"fax_number": "803-433-4601"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DENTAL WELLNESS CENTER EB5 VI LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "DENTAL WELLNESS CENTER EB5 VI LLC",
"enumeration_date": "2020-03-01",
"last_updated": "2020-03-01",
"certification_date": "2020-03-01",
"status": "A",
"authorized_official_last_name": "MATTHEWS",
"authorized_official_first_name": "SHARI",
"authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
"authorized_official_telephone_number": "843-599-9590"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Angel Dental Manning",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Dental Home EB5 VI, LLC",
"code": "4",
"type": "Former Legal Business Name"
}
]
}Other providers in Manning, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 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.