Pediatric Dentistry, PA

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

3515 Issued in SC

Legal business name

PEDIATRIC DENTISTRY, PA

Practice address

420 The Pkwy Ste B
Greer, SC 29650-5206

Phone

(864) 877-3232

Fax

(864) 677-3773

NPI assigned

Jan 18, 2007

Organization subpart

No

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

Authorized official

Name

Mark V Muncy, DMDNPI 1265565154

Title

Pedodontist

Phone

(864) 877-3232

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 4

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

• Mark V Muncy, DMD

  • Pediatric Dentistry
  • Greer, SC
  • NPI 1265565154
  NPD (past) Authorized official
• Colleen Danielle Cain, RDH

  • Dental Hygienist
  • Greenville, SC
  • NPI 1306357272
  NPD (past)
• Kathleen W Monn, DMD

  • Pediatric Dentistry
  • Greenville, SC
  • NPI 1083837660
  NPD (past)
• Keenan Webster Smith, DMD

  • General Practice Dentistry
  • Greenville, SC
  • NPI 1043419088

  Pediatric Dentistry

  NPD (past)

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306999115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 THE PKWY STE B",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296505206",
            "telephone_number": "864-877-3232",
            "fax_number": "864-677-3773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 THE PKWY STE B",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296505206",
            "telephone_number": "864-877-3232",
            "fax_number": "864-677-3773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTISTRY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MUNCY",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PEDODONTIST",
        "authorized_official_telephone_number": "864-877-3232",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "SC",
            "license": "3515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZA9647",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cameron Shawn Pawson, DPT
• Lauren Nicole Payton, DPT
• Peace From Pieces
• Pearl Assessments, LLC
• Howard Wayne Pearlman, M.D.
• Stefany Pedroza, LISW-CP
• Pee Dee Medical Transport of Sumter
• Haley Peek
• Pelham Anesthesia Services, LLC
• Pelham Falls Chiropractic

• Pediatric Dentistry in Greer, SC
• Providers in Greer, 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 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.