NPIMap

Organization Active NPI

Carolina Periodontics & Endodontics LLC

  • Endodontics
  • Rock Hill, SC
National Provider Identifier
1457666471
Registry record updated Aug 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
DENTAL: 4658 Issued in SC
Legal business name
CAROLINA PERIODONTICS & ENDODONTICS LLC
Practice address
1033 Bayshore Dr
Suite a
Rock Hill, SC 29732-1569
Phone
(803) 327-4444
Fax
(803) 327-4443
NPI assigned
Aug 13, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2010

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

Authorized official

Name
Dr. Chad Robert Matthews, DMDNPI 1225231228
Title
Periodontist/Owner
Phone
(803) 579-0026

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223E0200X DENTAL: 4658 SC Primary
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X DENTAL: 4667 SC

Addresses

Primary practice location

1033 Bayshore Dr
Suite a
Rock Hill, SC 29732-1569

Mailing address

1033 Bayshore Dr
Suite a
Rock Hill, SC 29732-1569
Phone (803) 327-4444

Other names 1

  • Palmetto Dental Specialists LLC Former legal business name

National Provider Directory

National Provider Directory

Locations

1033 Bayshore Dr
#A
Rock Hill, SC 29732
Phone (803) 327-4444

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": "1281657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281657600000",
    "number": "1457666471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1033 BAYSHORE DR",
            "address_2": "SUITE A",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321569",
            "telephone_number": "803-327-4444",
            "fax_number": "803-327-4443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1033 BAYSHORE DR",
            "address_2": "SUITE A",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321569",
            "telephone_number": "803-327-4444",
            "fax_number": "803-327-4443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA PERIODONTICS & ENDODONTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-13",
        "last_updated": "2010-08-13",
        "status": "A",
        "authorized_official_last_name": "MATTHEWS",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PERIODONTIST/OWNER",
        "authorized_official_telephone_number": "803-579-0026",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": "SC",
            "license": "DENTAL: 4658",
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "SC",
            "license": "DENTAL: 4667",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Palmetto Dental Specialists LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Rock Hill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2010; 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.