NPIMap

Organization Active NPI

Kool Smiles P.C.

  • General Practice Dentistry
  • Greenville, SC
National Provider Identifier
1235203886
Registry record updated Oct 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4543 Issued in SC
Legal business name
KOOL SMILES P.C.
Practice address
3227 W Blue Ridge Dr
Greenville, SC 29611-3905
Phone
(510) 290-4744
NPI assigned
Nov 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2009

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

Authorized official

Name
Dr. Angela C Black, DMDNPI 1437394467
Title
Dentist
Phone
(510) 290-4744

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 4543 SC Primary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X 4543 SC

Addresses

Primary practice location

3227 W Blue Ridge Dr
Greenville, SC 29611-3905

Mailing address

PO Box 67
Taylors, SC 29687-0002

National Provider Directory

National Provider Directory
Tax ID family
Kool Smiles PC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3227 W Blue Ridge Dr
Greenville, SC 29611
Phone (864) 295-8888

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256083200000",
    "number": "1235203886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 67",
            "city": "TAYLORS",
            "state": "SC",
            "postal_code": "296870002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3227 W BLUE RIDGE DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296113905",
            "telephone_number": "510-290-4744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOOL SMILES P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2009-10-21",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "510-290-4744",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "4543",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "SC",
            "license": "4543",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2009; 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.