Southeastern Dental Associates PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3746 Issued in SC

Legal business name

SOUTHEASTERN DENTAL ASSOCIATES PA

Practice address

4 Halton Green Way
Greenville, SC 29607-6606

Phone

(864) 283-2838

Fax

(864) 286-0560

NPI assigned

May 18, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Linda Wentworth Bridges, DDS

Title

Dentist

Phone

(864) 283-2838

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.

• Linda W Wentworth Bridges, DDS

  • General Practice Dentistry
  • Greenville, SC
  • NPI 1104944602
  NPD (past)

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467676800000",
    "number": "1396798567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 HALTON GREEN WAY",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296076606",
            "telephone_number": "864-283-2838",
            "fax_number": "864-286-0560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 HALTON GREEN WAY",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296076606",
            "telephone_number": "864-283-2838",
            "fax_number": "864-286-0560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN DENTAL ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2016-07-05",
        "status": "A",
        "authorized_official_last_name": "BRIDGES",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "WENTWORTH",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "864-283-2838",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "3746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Robert South, EMT
• Kelly Southard
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• General Practice Dentistry in Greenville, SC
• Providers in Greenville, 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 Jul 5, 2016; 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.