Omni Dental of Sumter LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

OMNI DENTAL OF SUMTER LLC

Practice address

625 Constitution Dr
Sumter, SC 29154-8190

Phone

(803) 773-5413

NPI assigned

Nov 7, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Robert Ellis, DMD

Title

Owner

Phone

(803) 413-5100

Specialties & licenses 1

Addresses

Practitioners 4

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

• Gary A Bethea, DDS

  • Dentist
  • Sumter, SC
  • NPI 1164797031
  NPD (past)
• Arian Latham Ray, D.D.S.

  • General Practice Dentistry
  • Sumter, SC
  • NPI 1427084581
  NPD (past)
• Washington Ray Jr., DDS

  • Dentist
  • Sumter, SC
  • NPI 1740396803
  NPD (past)
• Vatsal Suthar, D.M.D.

  • General Practice Dentistry
  • Sumter, SC
  • NPI 1902141682
  NPD (past)

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

{
    "created_epoch": "1730937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730937600000",
    "number": "1275356289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 OUTLET POINTE BLVD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292105667",
            "telephone_number": "803-830-3008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 CONSTITUTION DR",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291548190",
            "telephone_number": "803-773-5413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMNI DENTAL OF SUMTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-07",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-413-5100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ohio Valley Physicians, Inc
• Ohio Valley Physicians, Inc
• Nene Nwaobiara Nicole Okereke, M.D.
• Ugochukwu N Okereke, M.D.
• Lauren Bailey Olson
• Open Arms Home Care Agency, LLC
• Ortho Sport & Spine Physicians Sumter
• Orthodontic Specialists, L.L.C.
• Latinya M Ortiz, CNA
• George Effah Osei, MD

• Dental Clinic/Center in Sumter, SC
• Providers in Sumter, SC by specialty
• Dental Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.