NPIMap

Organization Active NPI

Family Dentistry Jared P. Tavernier DMD, PA

  • General Practice Dentistry
  • Ninety Six, SC
National Provider Identifier
1477936458
Registry record updated Jul 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8591 Issued in SC
Legal business name
FAMILY DENTISTRY JARED P. TAVERNIER DMD, PA
Practice address
321 N Cambridge St
Ninety Six, SC 29666-1012
Phone
(864) 543-4109
Fax
(864) 543-3246
NPI assigned
Jul 8, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2015

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

Authorized official

Name
Dr. Jared Preston Tavernier, D.M.D.NPI 1407239775
Title
Principal
Phone
(864) 934-3637

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 8591 SC Primary

Addresses

Primary practice location

321 N Cambridge St
Ninety Six, SC 29666-1012

Mailing address

321 N Cambridge St
Ninety Six, SC 29666-1012
Phone (864) 543-4109

National Provider Directory

National Provider Directory

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1436313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436313600000",
    "number": "1477936458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 N CAMBRIDGE ST",
            "city": "NINETY SIX",
            "state": "SC",
            "postal_code": "296661012",
            "telephone_number": "864-543-4109",
            "fax_number": "864-543-3246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 N CAMBRIDGE ST",
            "city": "NINETY SIX",
            "state": "SC",
            "postal_code": "296661012",
            "telephone_number": "864-543-4109",
            "fax_number": "864-543-3246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DENTISTRY JARED P. TAVERNIER DMD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-08",
        "last_updated": "2015-07-08",
        "status": "A",
        "authorized_official_last_name": "TAVERNIER",
        "authorized_official_first_name": "JARED",
        "authorized_official_middle_name": "PRESTON",
        "authorized_official_title_or_position": "PRINCIPAL",
        "authorized_official_telephone_number": "864-934-3637",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "8591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ninety Six, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2015; 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.