J Keith Bagwell DMD PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3413 Issued in SC

Legal business name

J KEITH BAGWELL DMD PA

Doing business as

riverside dental care

Practice address

1275 S Suber Rd
Greer, SC 29650-0940

Phone

(864) 877-2541

NPI assigned

Sep 19, 2014

Last updated

Sep 19, 2014By 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. James K BagwellNPI 1356542583

Title

President

Phone

(864) 877-2541

Specialties & licenses 1

Addresses

Other names 1

• riverside dental care Doing business as

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.

• James Keith Bagwell, D.M.D.

  • General Practice Dentistry
  • Greer, SC
  • NPI 1356542583
  NPD (past) Authorized official

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

{
    "created_epoch": "1411084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411084800000",
    "number": "1326440421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 S SUBER RD",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296500940",
            "telephone_number": "864-877-2541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 S SUBER RD",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296500940",
            "telephone_number": "864-877-2541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J KEITH BAGWELL DMD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-19",
        "last_updated": "2014-09-19",
        "status": "A",
        "authorized_official_last_name": "BAGWELL",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "864-877-2541",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "3413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "riverside dental care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cathy Hawkins Ipock, RPH
• Kyle Irish, PA
• Karen Melinda Isaacs, MD
• Bryan Isbell
• Keely Isbell
• Lasandra D Jackson, MD
• Melanie Jackson, M.D.
• Tyler Bradley Jackson, OTR/L
• Weston Jackson, DMD
• Timothy Donald James Jr., COTA/L

• General Practice Dentistry in Greer, SC
• Providers in Greer, SC by specialty
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2014; 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.