Powdersville Pediatric Dentistry, PA

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

3152 Issued in SC

Legal business name

POWDERSVILLE PEDIATRIC DENTISTRY, PA

Practice address

10705 Anderson Road
Easley, SC 29642

Phone

(864) 220-5437

Fax

(864) 220-0420

NPI assigned

Aug 3, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Melanie Richards, DMDNPI 1699965418

Title

Owner President

Phone

(864) 220-5437

Specialties & licenses 1

Addresses

Other identifiers 5

Locations

Practitioners 1

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

• Melanie Richards, DMD

  • Pediatric Dentistry
  • Walterboro, SC
  • NPI 1699965418
  NPD (past) Authorized official

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378684800000",
    "number": "1417965922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10705 ANDERSON ROAD",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "29642",
            "telephone_number": "864-220-5437",
            "fax_number": "864-220-0420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10705 ANDERSON ROAD",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "29642",
            "telephone_number": "864-220-5437",
            "fax_number": "864-220-0420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POWDERSVILLE PEDIATRIC DENTISTRY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2013-09-09",
        "status": "A",
        "authorized_official_last_name": "RICHARDS",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "864-220-5437",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "SC",
            "license": "3152",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "88009615",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "706109",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "214665",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "3126152",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZA9574",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julianne Pope, R.N.
• Anthony Porter
• Lisa Marie Porter, PT
• Tiffany C Porter, RPH
• Suzan R Potter
• Powdersville Pharmacy, PA
• Powdersville Wellness, LLC
• Rhett Powell
• Premier Pain Solutions PLLC
• Presbyterian Communities of South Carolina (Presbyterian Communities of SC - Foothills)

• Pediatric Dentistry in Easley, SC
• Providers in Easley, SC by specialty
• Pediatric Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2013; 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.