NPIMap

Organization Active NPI

Holly Tree Family Dental, PA

  • General Practice Dentistry
  • Simpsonville, SC
National Provider Identifier
1245994342
Registry record updated Oct 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
HOLLY TREE FAMILY DENTAL, PA
Practice address
1334 S. Highway 14
Simpsonville, SC 29681
Phone
(864) 297-5585
Fax
(864) 297-4166
NPI assigned
Oct 25, 2021
Organization subpart
Yes
Parent organization
HOLLY TREE FAMILY DENTAL, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 25, 2021

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

Authorized official

Name
Dr. Matthew James Bynum, DDS
Title
Owner
Phone
(864) 297-5585

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

1334 S. Highway 14
Simpsonville, SC 29681

Mailing address

1334 S. Highway 14
Simpsonville, SC 29681
Phone (864) 297-5585

Other names 1

  • Bynum Aesthetic Dentistry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Holly Tree Family Dental2 organizations share this tax ID, including this one
Part of
Holly Tree Family Dental

Other organizations with this tax ID 1

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

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": "1635120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635120000000",
    "number": "1245994342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1334 S. HIGHWAY 14",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "29681",
            "telephone_number": "864-297-5585",
            "fax_number": "864-297-4166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1334 S. HIGHWAY 14",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "29681",
            "telephone_number": "864-297-5585",
            "fax_number": "864-297-4166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLY TREE FAMILY DENTAL, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HOLLY TREE FAMILY DENTAL, PA",
        "enumeration_date": "2021-10-25",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A",
        "authorized_official_last_name": "BYNUM",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "864-297-5585",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bynum Aesthetic Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Simpsonville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2021; 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.