Palmetto Dental PA

Primary specialty

DentistTaxonomy code 122300000X

License

3101 Issued in SC

Legal business name

PALMETTO DENTAL PA

Practice address

701 Wilson St
Chester, SC 29706-8568

Phone

(803) 581-2080

Fax

(803) 581-2084

NPI assigned

Jan 24, 2007

Organization subpart

No

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

Authorized official

Name

Sharareh V Borhanian, D.M.D.

Title

Owner Dentist

Phone

(803) 581-2080

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Palmetto Dental PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Palmetto Dental PA

  • Dentist
  • Rock Hill, SC
  • NPI 1659333581
  NPD tax ID

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1154476679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 WILSON ST",
            "city": "CHESTER",
            "state": "SC",
            "postal_code": "297068568",
            "telephone_number": "803-581-2080",
            "fax_number": "803-581-2084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 WILSON ST",
            "city": "CHESTER",
            "state": "SC",
            "postal_code": "297068568",
            "telephone_number": "803-581-2080",
            "fax_number": "803-581-2084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO DENTAL PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BORHANIAN",
        "authorized_official_first_name": "SHARAREH",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "803-581-2080",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "SC",
            "license": "3101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZA9663",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Chester, SC
• Providers in Chester, SC by specialty
• Dentist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.

Verify at the official NPI Registry.