Active NPI
Patrick R Breaux, DDS,PA
- Dentist
- Greenville, SC
National Provider Identifier
1124266853
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2563
- Practice address
- 1412 Pelham Rd
Greenville, SC 29615-3921 - Phone
- (864) 234-7023
- Fax
- (864) 458-7650
- NPI assigned
- Feb 3, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2563 | SC | Primary |
Addresses
Primary practice location
1412 Pelham Rd
Greenville, SC 29615-3921
Mailing address
1412 Pelham Rd
Greenville, SC 29615-3921
Phone (864) 234-7023
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2563 | SC | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pelham Oaks Dental | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Greenville, SC
- NPI 1811046709
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1233619200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1233619200000",
"number": "1124266853",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1412 PELHAM RD",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296153921",
"telephone_number": "864-234-7023",
"fax_number": "864-458-7650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1412 PELHAM RD",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296153921",
"telephone_number": "864-234-7023",
"fax_number": "864-458-7650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BREAUX",
"first_name": "PATRICK",
"middle_name": "R",
"credential": "DDS,PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-02-03",
"last_updated": "2009-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "SC",
"license": "2563",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.