Organization Active NPI

Rivertown Dental Care

  • Dentist
  • Conway, SC
National Provider Identifier
1225075880
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
3690 Issued in SC
Legal business name
RIVERTOWN DENTAL CARE
Practice address
2608-B Main St
Conway, SC 29526
Phone
(843) 488-2501
Fax
(843) 488-2535
NPI assigned
Jun 1, 2006
Last updated
Aug 22, 2020By the provider in NPPES
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
Mr. Robert Chad Butler, DMDNPI 1962545350
Title
Dentist
Phone
(843) 488-2501

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 3690 SC Primary

Addresses

Primary practice location

2608-B Main St
Conway, SC 29526

Mailing address

2608-B Main St
Conway, SC 29526
Phone (843) 488-2501

Other identifiers 1

IdentifierTypeStateIssuer
2A9564MedicaidSC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1225075880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2608-B MAIN ST",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "29526",
            "telephone_number": "843-488-2501",
            "fax_number": "843-488-2535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2608-B MAIN ST",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "29526",
            "telephone_number": "843-488-2501",
            "fax_number": "843-488-2535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERTOWN DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "CHAD",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "843-488-2501",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "3690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2A9564",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, 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.