Carolina Pediatric Dentistry

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

3703 Issued in SC

Legal business name

CAROLINA PEDIATRIC DENTISTRY

Practice address

763 E. Main Street
Spartanburg, SC 29302

Phone

(864) 585-8558

Fax

(864) 580-4242

NPI assigned

Jun 3, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Amanda Spivey Green, DMDNPI 1588783344

Title

Dentist

Phone

(864) 585-8558

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Amanda S. Green, DMD

  • General Practice Dentistry
  • Spartanburg, SC
  • NPI 1588783344
  NPD Authorized official

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

{
    "created_epoch": "1307059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706659200000",
    "number": "1326332628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "763 E. MAIN STREET",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "29302",
            "telephone_number": "864-585-8558",
            "fax_number": "864-580-4242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "763 E. MAIN STREET",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "29302",
            "telephone_number": "864-585-8558",
            "fax_number": "864-580-4242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-03",
        "last_updated": "2024-01-31",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "SPIVEY",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "864-585-8558",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "SC",
            "license": "3703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZX3703",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carolina Homecare Medical Equipment Ctr
• Carolina Neurology of Spartanburg
• Carolina Orthopaedic and Neurosurgical Associates
• Carolina Orthopaedic and Neurosurgical Associates
• Carolina Orthotics and Prosthetics LLC
• Carolina Pedorthic, LLC
• Carolina Physical Medicine and
• Carolina Physicians and Rehab, LLC
• Carolina Plastic Surgery PA
• Carolina Professional Staffing, Inc.

• Dental Clinic/Center in Spartanburg, SC
• Providers in Spartanburg, SC by specialty
• Dental Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; 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.