NPIMap

Organization Active NPI

Family Dental Center, LLC

  • General Practice Dentistry
  • Greenville, SC
National Provider Identifier
1134409345
Registry record updated Aug 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
FAMILY DENTAL CENTER, LLC
Practice address
6134 White Horse Rd
Ste. C
Greenville, SC 29611-3837
Phone
(312) 274-0308
NPI assigned
Aug 18, 2011
Last updated
Aug 18, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2011

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

Authorized official

Name
Peter Stathakis
Title
Cfo
Phone
(312) 274-0308

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

6134 White Horse Rd
Ste. C
Greenville, SC 29611-3837

Mailing address

6134 White Horse Rd
Ste. C
Greenville, SC 29611-3837
Phone (312) 274-0308

National Provider Directory

National Provider Directory
Tax ID family
Family Dental Center LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6134 White Horse Rd
Ste C
Greenville, SC 29611
Phone (864) 295-2744

NPI Registry JSON

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

{
    "created_epoch": "1313625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313625600000",
    "number": "1134409345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6134 WHITE HORSE RD",
            "address_2": "STE. C",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296113837",
            "telephone_number": "312-274-0308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6134 WHITE HORSE RD",
            "address_2": "STE. C",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296113837",
            "telephone_number": "312-274-0308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DENTAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-18",
        "last_updated": "2011-08-18",
        "status": "A",
        "authorized_official_last_name": "STATHAKIS",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "312-274-0308"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "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 Aug 18, 2011; 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.