NPIMap

Organization Active NPI

Dental Professionals of South Carolina, P.C.

  • General Practice Dentistry
  • Columbia, SC
National Provider Identifier
1154714079
Registry record updated Mar 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL PROFESSIONALS OF SOUTH CAROLINA, P.C.
Practice address
9360 Two Notch Rd
Columbia, SC 29223-6416
Phone
(803) 788-0360
NPI assigned
Mar 17, 2015
Organization subpart
Yes
Parent organization
DENTAL PROFESSIONALS OF SOUTH CAROLINA, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 17, 2015

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

Authorized official

Name
Kim Wilson
Title
Cred Supervisor
Phone
(217) 540-5170

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

9360 Two Notch Rd
Columbia, SC 29223-6416

Mailing address

9360 Two Notch Rd
Columbia, SC 29223-6416

Other names 1

  • Family Dental Care of Spring Valley Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dental Professional of South Carolina PC74 organizations share this tax ID, including this one
Part of
Dental Professional of South Carolina PC

Organizations with this tax ID in the same state 23

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 23

Locations

9360 Two Notch Rd
Columbia, SC 29223
Phone (803) 788-0360

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1426550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426550400000",
    "number": "1154714079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9360 TWO NOTCH RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292236416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9360 TWO NOTCH RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292236416",
            "telephone_number": "803-788-0360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL PROFESSIONALS OF SOUTH CAROLINA, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL PROFESSIONALS OF SOUTH CAROLINA, P.C.",
        "enumeration_date": "2015-03-17",
        "last_updated": "2015-03-17",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "CRED SUPERVISOR",
        "authorized_official_telephone_number": "217-540-5170"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Dental Care of Spring Valley",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.