Clemson Dental Associates, PA

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

CLEMSON DENTAL ASSOCIATES, PA

Practice address

211 Pendleton Rd # 10
Clemson, SC 29631-2262

Phone

(864) 654-0230

NPI assigned

Jan 11, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Laureen Walsh

Title

Secretary Treasurer

Phone

(864) 324-1392

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265582555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 PENDLETON RD # 10",
            "city": "CLEMSON",
            "state": "SC",
            "postal_code": "296312262",
            "telephone_number": "864-654-0230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 PENDLETON RD # 10",
            "city": "CLEMSON",
            "state": "SC",
            "postal_code": "296312262",
            "telephone_number": "864-654-0230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEMSON DENTAL ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALSH",
        "authorized_official_first_name": "LAUREEN",
        "authorized_official_title_or_position": "SECRETARY TREASURER",
        "authorized_official_telephone_number": "864-324-1392"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Clemson, SC
• Providers in Clemson, SC by specialty
• Dentist in South Carolina

• 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.