Individual provider Active NPI

Bryan B. Patterson, DMD

  • General Practice Dentistry
  • Florence, SC
National Provider Identifier
1427020924
Registry record updated Apr 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3948 Issued in SC
Practice address
1840 Second Loop Rd
Florence, SC 29501
Phone
(843) 662-1761
Fax
(843) 662-2740
NPI assigned
Feb 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3948 SC Primary

Addresses

Primary practice location

1840 Second Loop Rd
Florence, SC 29501

Mailing address

1840 Second Loop Rd
Florence, SC 29501
Phone (843) 662-1761

Other identifiers 1

IdentifierTypeStateIssuer
2X3948MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3948SCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Florence Family Dental Care PA General Practice CurrentSince May 31, 2020 Accepting new patients

Locations

1840 2nd Loop Rd
Florence, SC 29501
Phone (843) 662-1761

519 W Palmetto St
Florence, SC 29501
Phone (843) 662-1761

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585785600000",
    "number": "1427020924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1840 SECOND LOOP RD",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "29501",
            "telephone_number": "843-662-1761",
            "fax_number": "843-662-2740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 SECOND LOOP RD",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "29501",
            "telephone_number": "843-662-1761",
            "fax_number": "843-662-2740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "BRYAN",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2020-04-02",
        "certification_date": "2020-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "3948",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2X3948",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2020; 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.