Pediatric Dentistry of Greenwood, P.a.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

SC4112 Issued in SC

Legal business name

PEDIATRIC DENTISTRY OF GREENWOOD, P.A.

Practice address

1202B Hwy 72 W
Greenwood, SC 29649-1816

Phone

(864) 229-0305

NPI assigned

Oct 7, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Jennifer Balkcum TurnerNPI 1720165558

Title

Dentist

Phone

(864) 229-0305

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

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

• Jennifer Balkcum Turner, D.M.D.

  • Dentist
  • Greenwood, SC
  • NPI 1720165558
  NPD (past) Authorized official

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

{
    "created_epoch": "1223337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223337600000",
    "number": "1215188388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202B HWY 72 W",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296491816",
            "telephone_number": "864-229-0305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202B HWY 72 W",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296491816",
            "telephone_number": "864-229-0305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTISTRY OF GREENWOOD, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-07",
        "last_updated": "2008-10-07",
        "status": "A",
        "authorized_official_last_name": "TURNER",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "BALKCUM",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "864-229-0305",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "SC",
            "license": "SC4112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZX4050",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZX4112",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Joel Paulsen Sr.
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• Ashlann Peacon
• Peak Performance Therapy Services, LLC
• Patricia Lida Pena, RN
• Whitney Pence, PHARMD
• Leah P. Perez, M.D.
• Tacey Anne Perillo, LMFT
• Breoina Pernell

• Pediatric Dentistry in Greenwood, SC
• Providers in Greenwood, SC by specialty
• Pediatric Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2008; 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.