NPIMap

Organization Active NPI

Reynolds Family Dentistry, PA

  • General Practice Dentistry
  • Clinton, SC
National Provider Identifier
1275748063
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3705 Issued in SC
Legal business name
REYNOLDS FAMILY DENTISTRY, PA
Practice address
85 Professional Park Road
Clinton, SC 29325
Phone
(864) 938-6002
Fax
(864) 938-6589
NPI assigned
May 14, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Seth C Reynolds, DMDNPI 1386859171
Title
Dentist, President
Phone
(864) 938-6002

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 3705 SC Primary

Addresses

Primary practice location

85 Professional Park Road
Clinton, SC 29325

Mailing address

PO Box 265
Laurens, SC 29360-0265
Phone (864) 938-6002

Other identifiers 1

IdentifierTypeStateIssuer
ZA9666MedicaidSC

National Provider Directory

National Provider Directory

Locations

85 Professional Park Rd
Clinton, SC 29325
Phone (864) 938-6002

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275748063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 265",
            "city": "LAURENS",
            "state": "SC",
            "postal_code": "293600265",
            "telephone_number": "864-938-6002",
            "fax_number": "864-938-6589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 PROFESSIONAL PARK ROAD",
            "city": "CLINTON",
            "state": "SC",
            "postal_code": "29325",
            "telephone_number": "864-938-6002",
            "fax_number": "864-938-6589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REYNOLDS FAMILY DENTISTRY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS",
        "authorized_official_first_name": "SETH",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DENTIST, PRESIDENT",
        "authorized_official_telephone_number": "864-938-6002",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "3705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZA9666",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, SC

Sources for this page

  • 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.