Individual provider Active NPI

Sarah Elizabeth Jardin Ray, DMD

  • General Practice Dentistry
  • West Columbia, SC
National Provider Identifier
1447006267
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8991 Issued in SC
Practice address
125 Medical Cir
West Columbia, SC 29169-3655
Phone
(803) 796-2637
NPI assigned
Apr 24, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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 8991 SC Primary

Addresses

Primary practice location

125 Medical Cir
West Columbia, SC 29169-3655

Mailing address

1130 Powerline Rd
Lugoff, SC 29078-9791
Phone (843) 531-3440

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
8991SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Karen Park Family Dentistry, P.a. PastSince Apr 28, 2024 Accepting new patients

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": "1713916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1447006267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 POWERLINE RD",
            "city": "LUGOFF",
            "state": "SC",
            "postal_code": "290789791",
            "telephone_number": "843-531-3440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 MEDICAL CIR",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291693655",
            "telephone_number": "803-796-2637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARDIN RAY",
        "first_name": "SARAH",
        "middle_name": "ELIZABETH",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-24",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "8991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.

Verify at the official NPI Registry.