Active NPI
Kyle Maldonado, DMD
- Dentist
- Spartanburg, SC
National Provider Identifier
1437993789
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DGD.10825
- Practice address
- 631 N Church St
Spartanburg, SC 29303-3046 - Phone
- (864) 308-1389
- NPI assigned
- Jun 21, 2024
- Last updated
- Jun 21, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DGD.10825 | SC | Primary |
| General Practice Dentistry | 1223G0001X | DGD.10825 | SC |
Addresses
Primary practice location
631 N Church St
Spartanburg, SC 29303-3046
Mailing address
2428 Park View Greer Cir
Greer, SC 29651
Phone (908) 655-5735
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
| License | State | Type | Specialty |
|---|---|---|---|
| DGD.10825 | SC | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718928000000",
"number": "1437993789",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2428 PARK VIEW GREER CIR",
"city": "GREER",
"state": "SC",
"postal_code": "29651",
"telephone_number": "908-655-5735"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "631 N CHURCH ST",
"city": "SPARTANBURG",
"state": "SC",
"postal_code": "293033046",
"telephone_number": "864-308-1389"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALDONADO",
"first_name": "KYLE",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-06-21",
"last_updated": "2024-06-21",
"certification_date": "2024-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "SC",
"license": "DGD.10825",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "SC",
"license": "DGD.10825",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spartanburg, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.