Upstate Pediatric Dentistry, PA

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

UPSTATE PEDIATRIC DENTISTRY, PA

Practice address

105-A Halton Road
Greenville, SC 29607-3507

Phone

(864) 676-9873

Fax

(864) 676-9870

NPI assigned

Aug 19, 2008

Last updated

Aug 19, 2008By 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

Dr. Brian Timothy Jones, DMDNPI 1548225659

Title

Dentist

Phone

(864) 676-9873

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Brian Timothy Jones, DMD

  • Pediatric Dentistry
  • Greenville, SC
  • NPI 1548225659
  Authorized official Same address or phone

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

{
    "created_epoch": "1219104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219104000000",
    "number": "1275780454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105-A HALTON ROAD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296073507",
            "telephone_number": "864-676-9873",
            "fax_number": "864-676-9870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105-A HALTON ROAD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296073507",
            "telephone_number": "864-676-9873",
            "fax_number": "864-676-9870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPSTATE PEDIATRIC DENTISTRY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-19",
        "last_updated": "2008-08-19",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "TIMOTHY",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "864-676-9873",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Upstate Pathology, PA
• Upstate Pharmacy Ima
• Upstate Prosthetics LLC
• Upstate Prosthodontics, L.L.C.
• Upstate Psychiatry, PA
• Upstate Psychotherapy, LLC

• Pediatric Dentistry in Greenville, SC
• Providers in Greenville, 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 19, 2008; 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.