Ronald Kent Bracey, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3765 Issued in SC

Practice address

101 E Jackson St
Dillon, SC 29536-2421

Phone

(843) 774-7662

Fax

(843) 774-7920

NPI assigned

May 15, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dillon Family Dental Center PC

  • General Practice Dentistry
  • Dillon, SC
  • NPI 1942226386

  General Practice

  NPD (past)

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235345331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 N 18TH AVE",
            "city": "DILLON",
            "state": "SC",
            "postal_code": "295362754",
            "telephone_number": "843-841-9383",
            "fax_number": "843-774-7920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E JACKSON ST",
            "city": "DILLON",
            "state": "SC",
            "postal_code": "295362421",
            "telephone_number": "843-774-7662",
            "fax_number": "843-774-7920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACEY",
        "first_name": "RONALD",
        "middle_name": "KENT",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "3765",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "899016X",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZX3765",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Teonna Bethea
• Bio-Medical Applications of South Carolina, Inc.
• Bliss Family Aid LLC
• Jonathan Basil Boggs, PHARM D
• John F Bracey, DC
• Suzanna Montes Bran
• Loryn Jackson Britt, FNP
• David Brown, RPH
• Michael N Brown, M.D.
• Raymond Brown, PA-C

• All providers in Dillon, SC
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.