Palmetto Periodontics LLC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Legal business name

PALMETTO PERIODONTICS LLC

Practice address

124 Alpine Cir
Columbia, SC 29223-6385

Phone

(803) 788-0900

Fax

(803) 788-0637

NPI assigned

Nov 1, 2023

Organization subpart

No

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

Authorized official

Name

Dr. James P Wilson, DMDNPI 1518414630

Title

Owner/Periodontist

Phone

(803) 788-0900

Specialties & licenses 1

Addresses

Other names 1

• James Wilson DMD LLC Former legal business name

Locations

Practitioners 2

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

• James Patrick Wilson, DMD, MS

  • Periodontics
  • Columbia, SC
  • NPI 1518414630
  NPD Authorized official
• Gregg Walker McKenzie, DDS

  • Periodontics
  • Columbia, SC
  • NPI 1427029511
  NPD (past)

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

{
    "created_epoch": "1698796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742428800000",
    "number": "1174396105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 ALPINE CIR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292236385",
            "telephone_number": "803-788-0900",
            "fax_number": "803-788-0637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 ALPINE CIR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292236385",
            "telephone_number": "803-788-0900",
            "fax_number": "803-788-0637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO PERIODONTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-01",
        "last_updated": "2025-03-20",
        "certification_date": "2023-11-01",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER/PERIODONTIST",
        "authorized_official_telephone_number": "803-788-0900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "James Wilson DMD LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Palmetto Pain Management, LLC
• Palmetto Ped Gastro and Nut
• Palmetto Pediatric
• Palmetto Pediatric Gastro and Nutrition
• Palmetto Pediatric Gastroenterology
• Palmetto Podiatry Associates LLC
• Palmetto Primary Care Physicians, LLC
• Palmetto Primary Care Physicians, LLC
• Palmetto Primary Care Physicians, LLC
• Palmetto Primary Care Physicians, LLC

• Periodontics in Columbia, SC
• Providers in Columbia, SC by specialty
• Periodontics in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2025; 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.