Organization Active NPI

Lifetime Family Dentistry LLC

  • General Practice Dentistry
  • Laurens, SC
National Provider Identifier
1457337495
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3380 Issued in SC
Legal business name
LIFETIME FAMILY DENTISTRY LLC
Practice address
310 Owings St
Laurens, SC 29360-2738
Phone
(864) 984-6888
Fax
(864) 984-4474
NPI assigned
Dec 21, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Suzanne M Lowry
Title
Office Manager
Phone
(864) 984-6888

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4036 SC
General Practice Dentistry 1223G0001X 3380 SC Primary

Addresses

Primary practice location

310 Owings St
Laurens, SC 29360-2738

Mailing address

310 Owings St
Laurens, SC 29360-2738
Phone (864) 984-6888

Other identifiers 1

IdentifierTypeStateIssuer
ZA9540MedicaidSC

National Provider Directory

National Provider Directory

Locations

310 Owings St
Laurens, SC 29360
Phone (540) 629-0302

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1135123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1457337495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 OWINGS ST",
            "city": "LAURENS",
            "state": "SC",
            "postal_code": "293602738",
            "telephone_number": "864-984-6888",
            "fax_number": "864-984-4474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 OWINGS ST",
            "city": "LAURENS",
            "state": "SC",
            "postal_code": "293602738",
            "telephone_number": "864-984-6888",
            "fax_number": "864-984-4474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFETIME FAMILY DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LOWRY",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "864-984-6888",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "4036",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "3380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZA9540",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurens, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.