Andrew Bott, D.M.D.
Individual provider Active NPI General Practice Dentistry · Spartanburg, SC
NPI 1124257969 · NPPES record last updated Jul 14, 2009
Key facts
- NPI
- 1124257969
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 4627 (SC)
- Practice address
- 1585 Skylyn Dr
Spartanburg, SC 29307-1034 - Phone
- (864) 573-9255
- Fax
- (864) 585-8188
- NPI assigned
- Jul 14, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
- Opted out of Medicare
- Yes, effective Oct 9, 2017 through Oct 9, 2027
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4627 | SC | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Skylyn Dental Associates LLC | Past |
Accepting new patients | |
| Woodruff Family Dentistry | General Practice | Past | Accepting new patients |
| John F Dunbar Jr DMD PA | General Practice | Past | Accepting new patients |
| Crowns Now Greer, Inc | Past | Accepting new patients | |
| Crowns Now Family Dentistry | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 4627 | SC | Yes |
Addresses
Primary practice location
1585 Skylyn Dr
Spartanburg, SC 29307-1034
Mailing address
1585 Skylyn Dr
Spartanburg, SC 29307-1034
Phone (864) 573-9255
Other providers in Spartanburg, SC
- Bonnie Boswell Boone
- Neil Borad
- Danni Moss Borron
- Joseph A Boscia III
- Roxie D Bosier
- James G Botts
- Richard Paul Boudreau
- Lauren Boughman
- Patricia Jean Bouknight
- Amy Lynne Boulton
All providers in Spartanburg, SC · General Practice Dentistry in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 14, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.