NPIMap

Organization Active NPI

Dental Associates of Holly Hill PA

  • General Practice Dentistry
  • Holly Hill, SC
National Provider Identifier
1164553178
Registry record updated Aug 22, 2020
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Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DC41076-1 Issued in SC
Legal business name
DENTAL ASSOCIATES OF HOLLY HILL PA
Practice address
912 Holly Street
Holly Hill, SC 29059-0606
Phone
(803) 496-5093
Fax
(803) 496-5093
NPI assigned
Mar 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ivan Anderson Bishop Jr., D.D.S.
Title
Prestident
Phone
(803) 496-5093

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DC41076-1 SC Primary

Addresses

Primary practice location

912 Holly Street
Holly Hill, SC 29059-0606

Mailing address

PO Box 606
Holly Hill, SC 29059-0606
Phone (803) 496-5093

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164553178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 606",
            "city": "HOLLY HILL",
            "state": "SC",
            "postal_code": "290590606",
            "telephone_number": "803-496-5093",
            "fax_number": "803-496-5093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 HOLLY STREET",
            "city": "HOLLY HILL",
            "state": "SC",
            "postal_code": "290590606",
            "telephone_number": "803-496-5093",
            "fax_number": "803-496-5093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL ASSOCIATES OF HOLLY HILL PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BISHOP",
        "authorized_official_first_name": "IVAN",
        "authorized_official_middle_name": "ANDERSON",
        "authorized_official_title_or_position": "PRESTIDENT",
        "authorized_official_telephone_number": "803-496-5093",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "DC41076-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holly Hill, SC

Sources for this page

  • 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.