Organization Active NPI

Trinity Park Dentistry ,PC

  • General Practice Dentistry
  • Simpsonville, SC
National Provider Identifier
1285382879
Registry record updated Mar 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
TRINITY PARK DENTISTRY ,PC
Practice address
2200 Woodruff Rd Ste 400a-B
Simpsonville, SC 29681-5475
Phone
(864) 565-8531
Fax
(864) 568-3841
NPI assigned
Mar 14, 2022
Last updated
Mar 14, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2022

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

Authorized official

Name
Ali Shahrestani, DMD
Title
Owner
Phone
(864) 565-8531

Specialties & licenses 1

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

Addresses

Primary practice location

2200 Woodruff Rd Ste 400a-B
Simpsonville, SC 29681-5475

Mailing address

PO Box 920050
Dallas, TX 75392-0050
Phone (714) 845-8890

National Provider Directory

National Provider Directory

Locations

2200 Woodruff Rd
Ste 400AB
Simpsonville, SC 29681
Phone (864) 565-8531

NPI Registry JSON

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

{
    "created_epoch": "1647216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647216000000",
    "number": "1285382879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753920050",
            "telephone_number": "714-845-8890",
            "fax_number": "303-952-0892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 WOODRUFF RD STE 400A-B",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296815475",
            "telephone_number": "864-565-8531",
            "fax_number": "864-568-3841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY PARK DENTISTRY ,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-14",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A",
        "authorized_official_last_name": "SHAHRESTANI",
        "authorized_official_first_name": "ALI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "864-565-8531",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simpsonville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2022; 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.