Powdersville Family Dentistry, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

POWDERSVILLE FAMILY DENTISTRY, LLC

Practice address

102 Clair Dr
Powdersville, SC 29673-7771

Phone

(864) 269-3662

NPI assigned

Dec 19, 2017

Organization subpart

No

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

Authorized official

Name

Dr. John Kennedy Jr., DMD

Title

Owner

Phone

(864) 386-2753

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Tami Cimand, DMD

  • Dentist
  • Piedmont, SC
  • NPI 1558571380
  NPD (past)

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

{
    "created_epoch": "1513641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513641600000",
    "number": "1326554841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31625",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296081625",
            "telephone_number": "864-501-0070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 CLAIR DR",
            "city": "POWDERSVILLE",
            "state": "SC",
            "postal_code": "296737771",
            "telephone_number": "864-269-3662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POWDERSVILLE FAMILY DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-19",
        "last_updated": "2017-12-19",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "864-386-2753",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Michelle Giroux, MD
• Sacha H Gutierrez, M.D.
• Ingles Markets Inc
• Omscor LLC
• Amar Prakash Patel, DMD
• Salubrius Pharmacy, LLC
• Eugene Sibal, D.M.D
• Wal-Mart Stores East, LP
• Amanda Monique Walker, PHARMD
• Ashley Wells, M.D.

• Dental Clinic/Center in Powdersville, SC
• Providers in Powdersville, 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 Dec 19, 2017; 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.