Summerville Pediatric Dentistry

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

3903 Issued in SC

Legal business name

SUMMERVILLE PEDIATRIC DENTISTRY

Practice address

405 W 5TH North St Ste a
Summerville, SC 29483-6515

Phone

(843) 871-6433

NPI assigned

Aug 3, 2009

Organization subpart

No

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

Authorized official

Name

Dorothy M Baker, DMD PC

Title

Owner

Phone

(873) 871-6433

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1249257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249257600000",
    "number": "1275764672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 W 5TH NORTH ST STE A",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294836515",
            "telephone_number": "843-871-6433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 W 5TH NORTH ST STE A",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294836515",
            "telephone_number": "843-871-6433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMERVILLE PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-03",
        "last_updated": "2009-08-03",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "DOROTHY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "873-871-6433",
        "authorized_official_credential": "DMD PC"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "SC",
            "license": "3903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Dentistry in Summerville, SC
• Providers in Summerville, SC by specialty
• Pediatric Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2009; 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.