Berea Dental Care LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

SC4479 Issued in SC

Legal business name

BEREA DENTAL CARE LLC

Practice address

1906 Cedar Lane Rd
Greenville, SC 29617-1733

Phone

(864) 235-3949

NPI assigned

Nov 4, 2010

Last updated

Nov 4, 2010By 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

Mrs. Tammie R Foster

Title

Office Administrator

Phone

(864) 235-3949

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1288828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288828800000",
    "number": "1194026310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1906 CEDAR LANE RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296171733",
            "telephone_number": "864-235-3949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 CEDAR LANE RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296171733",
            "telephone_number": "864-235-3949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEREA DENTAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-04",
        "last_updated": "2010-11-04",
        "status": "A",
        "authorized_official_last_name": "FOSTER",
        "authorized_official_first_name": "TAMMIE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "864-235-3949",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "SC4479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Greenville, SC
• Providers in Greenville, SC by specialty
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2010; 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.