Active NPI
Pee Dee Pediatric Dentistry
- Pediatric Dentistry
- Florence, SC
National Provider Identifier
1316076516
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 2248
- Legal business name
- PEE DEE PEDIATRIC DENTISTRY
- Practice address
- 1423 Alice Dr
Florence, SC 29505-2660 - Phone
- (843) 667-6660
- Fax
- (843) 661-0836
- NPI assigned
- Mar 5, 2007
- Last updated
- Feb 20, 2012
- Organization subpart
- Yes
- Parent organization
- PEE DEE PEDIATRIC DENTISTY
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Richard Hartwell Bryant Jr., DMD
- Title
- Dentist
- Phone
- (843) 667-6660
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 2248 | SC | Primary |
Addresses
Primary practice location
1423 Alice Dr
Florence, SC 29505-2660
Mailing address
1423 Alice Dr
Florence, SC 29505-2660
Phone (843) 667-6660
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZA9697 | Medicaid | SC |
National Provider Directory
National Provider Directory- Part of
- Pee Dee Pediatric Dentistry
Locations
1423 Alice Dr
Florence, SC 29505
Phone (843) 667-6660
Practitioners & affiliated clinicians
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.
-
- Pediatric Dentistry
- Florence, SC
- NPI 1316926173
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173052800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1329696000000",
"number": "1316076516",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1423 ALICE DR",
"city": "FLORENCE",
"state": "SC",
"postal_code": "295052660",
"telephone_number": "843-667-6660",
"fax_number": "843-661-0836"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1423 ALICE DR",
"city": "FLORENCE",
"state": "SC",
"postal_code": "295052660",
"telephone_number": "843-667-6660",
"fax_number": "843-661-0836"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PEE DEE PEDIATRIC DENTISTRY",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "PEE DEE PEDIATRIC DENTISTY",
"enumeration_date": "2007-03-05",
"last_updated": "2012-02-20",
"status": "A",
"authorized_official_last_name": "BRYANT",
"authorized_official_first_name": "RICHARD",
"authorized_official_middle_name": "HARTWELL",
"authorized_official_title_or_position": "DENTIST",
"authorized_official_telephone_number": "843-667-6660",
"authorized_official_name_prefix": "Dr.",
"authorized_official_name_suffix": "Jr.",
"authorized_official_credential": "DMD"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "SC",
"license": "2248",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "ZA9697",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Florence, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.