GD SC Wesmark, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

GD SC WESMARK, LLC

Doing business as

Wesmark Family Dentistry

Practice address

360 W Wesmark Blvd
Sumter, SC 29150-1977

Phone

(803) 469-2061

NPI assigned

Mar 17, 2023

Organization subpart

No

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

Authorized official

Name

Chad Hendricks

Title

Credentialing

Phone

(612) 859-0444

Specialties & licenses 1

Addresses

Other names 1

• Wesmark Family Dentistry Doing business as

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

{
    "created_epoch": "1679011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679011200000",
    "number": "1417659269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 W WESMARK BLVD",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291501977",
            "telephone_number": "803-469-2061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 W WESMARK BLVD",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291501977",
            "telephone_number": "803-469-2061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GD SC WESMARK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-17",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A",
        "authorized_official_last_name": "HENDRICKS",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "612-859-0444"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wesmark Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Sumter, SC
• Providers in Sumter, 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 Mar 17, 2023; 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.