NPIMap

Organization Active NPI

Advanced Endodontics of Aiken PC

  • Endodontics
  • Aiken, SC
National Provider Identifier
1124320353
Registry record updated Feb 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
4058 Issued in SC
Legal business name
ADVANCED ENDODONTICS OF AIKEN PC
Practice address
20 Tea Olive CT
Aiken, SC 29803-7543
Phone
(803) 648-0056
Fax
(803) 648-0057
NPI assigned
Nov 19, 2010
Last updated
Feb 1, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2012

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

Authorized official

Name
Ms. Margie Cervantes
Title
Office Manager
Phone
(803) 648-0056

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X 4058 SC Primary

Addresses

Primary practice location

20 Tea Olive CT
Aiken, SC 29803-7543

Mailing address

20 Tea Olive Court
Aiken, SC 29803-7543
Phone (803) 648-0056

National Provider Directory

National Provider Directory

Locations

20 Tea Olive Ct
Aiken, SC 29803
Phone (803) 226-9472

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1290124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328054400000",
    "number": "1124320353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 TEA OLIVE COURT",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298037543",
            "telephone_number": "803-648-0056",
            "fax_number": "803-648-0057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 TEA OLIVE CT",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298037543",
            "telephone_number": "803-648-0056",
            "fax_number": "803-648-0057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED ENDODONTICS OF AIKEN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-19",
        "last_updated": "2012-02-01",
        "status": "A",
        "authorized_official_last_name": "CERVANTES",
        "authorized_official_first_name": "MARGIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "803-648-0056",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "SC",
            "license": "4058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aiken, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2012; 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.