Victory Dental Center, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

4382 Issued in SC

Legal business name

VICTORY DENTAL CENTER, LLC

Practice address

9787 Charlotte Highway
Suite 201
Indian Land, SC 29707-5511

Phone

(803) 579-9775

NPI assigned

Oct 26, 2009

Last updated

Mar 20, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Cedrick Brown McDonald, DDSNPI 1811197460

Title

Dentist/Owner

Phone

(803) 547-2280

Specialties & licenses 1

Addresses

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.

• Cedrick Brown McDonald, DDS

  • General Practice Dentistry
  • Indian Land, SC
  • NPI 1811197460
  Authorized official Same address or phone
• Brandi Alexandria Magana, DMD

  • General Practice Dentistry
  • Indian Land, SC
  • NPI 1821510892
  NPD (past)

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

{
    "created_epoch": "1256515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426809600000",
    "number": "1154657229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9787 CHARLOTTE HIGHWAY",
            "address_2": "SUITE 201",
            "city": "INDIAN LAND",
            "state": "SC",
            "postal_code": "297075511",
            "telephone_number": "803-547-2280",
            "fax_number": "803-547-4208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9787 CHARLOTTE HIGHWAY",
            "address_2": "SUITE 201",
            "city": "INDIAN LAND",
            "state": "SC",
            "postal_code": "297075511",
            "telephone_number": "803-579-9775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY DENTAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-26",
        "last_updated": "2015-03-20",
        "status": "A",
        "authorized_official_last_name": "MCDONALD",
        "authorized_official_first_name": "CEDRICK",
        "authorized_official_middle_name": "BROWN",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "803-547-2280",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "SC",
            "license": "4382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mauricio Valencia, M.D.
• Ryan Valencic, D.C.
• Valerie L. Yaniszewski, DMD, PC (Smiles in the Sun)
• Emma Ventura
• Victory Dental Center
• Victory Dentistry for Kids
• Seth Patrick Vining, MD
• Lindsay Collins Waddell, PA-C
• Wal-Mart Stores East LP (Walmart Pharmacy 10-4237)
• Wal-Mart Stores East LP (Vision Center 30-4237)

• Dental Clinic/Center in Indian Land, SC
• Providers in Indian Land, SC by specialty
• Dental Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2015; 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.