NPIMap

Organization Active NPI

Dental Professional of South Carolina, P.C.

Doing business as Brighton Park Dental Care

  • General Practice Dentistry
  • Summerville, SC
National Provider Identifier
1275340879
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL PROFESSIONAL OF SOUTH CAROLINA, P.C.
Doing business as
Brighton Park Dental Care
Practice address
1264 Nexton Pkwy Ste 2021264
Summerville, SC 29486-2167
Phone
(854) 264-5100
Fax
(854) 264-5200
NPI assigned
Dec 17, 2024
Last updated
Dec 17, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
DENTAL PROFESSIONAL OF SOUTH CAROLINA, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Authorized official

Name
Hillary Thull
Title
Credentialing Coordinator
Phone
(217) 540-8946

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

1264 Nexton Pkwy Ste 2021264
Summerville, SC 29486-2167

Mailing address

1264 Nexton Pkwy Ste 2021264
Summerville, SC 29486-2167

Other names 1

  • Brighton Park Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dental Professionals of SC PC74 organizations share this tax ID, including this one
Part of
Dental Professionals of SC PC

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

1264 Nexton Pkwy
Ste 2021264
Summerville, SC 29486
Phone (854) 264-5100

NPI Registry JSON

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

{
    "created_epoch": "1734393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734393600000",
    "number": "1275340879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1264 NEXTON PKWY STE 2021264",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294862167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1264 NEXTON PKWY STE 2021264",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294862167",
            "telephone_number": "854-264-5100",
            "fax_number": "854-264-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL PROFESSIONAL OF SOUTH CAROLINA, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL PROFESSIONAL OF SOUTH CAROLINA, P.C.",
        "enumeration_date": "2024-12-17",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A",
        "authorized_official_last_name": "THULL",
        "authorized_official_first_name": "HILLARY",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-8946"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brighton Park Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Summerville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2024; 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.