Organization Active NPI

Dental Professional of South Carolina, P.C.

Doing business as Dental Care of Boiling Springs

  • General Practice Dentistry
  • Boiling Springs, SC
National Provider Identifier
1487902342
Registry record updated Aug 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL PROFESSIONAL OF SOUTH CAROLINA, P.C.
Doing business as
Dental Care of Boiling Springs
Practice address
2210 Boiling Springs Rd
Boiling Springs, SC 29316-5302
Phone
(864) 699-9858
Fax
(864) 699-9863
NPI assigned
Aug 27, 2012
Last updated
Aug 27, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
DENTAL PROFESSIONAL OF SOUTH CAROLINA, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 27, 2012

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

Authorized official

Name
Pam Hardiek
Title
Insurance/Credentialing
Phone
(217) 540-5100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

2210 Boiling Springs Rd
Boiling Springs, SC 29316-5302

Mailing address

2210 Boiling Springs Rd
Boiling Springs, SC 29316-5302
Phone (864) 699-9858

Other names 1

  • Dental Care of Boiling Springs Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dental Professionals of SC PC74 organizations share this tax ID, including this one
Part of
Dental Professionals of SC PC

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

2210 Boiling Springs Rd
Boiling Springs, SC 29316
Phone (864) 699-9858

Practitioners & affiliated clinicians

Practitioners 4

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": "1346025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346025600000",
    "number": "1487902342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 BOILING SPRINGS RD",
            "city": "BOILING SPRINGS",
            "state": "SC",
            "postal_code": "293165302",
            "telephone_number": "864-699-9858",
            "fax_number": "864-699-9863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 BOILING SPRINGS RD",
            "city": "BOILING SPRINGS",
            "state": "SC",
            "postal_code": "293165302",
            "telephone_number": "864-699-9858",
            "fax_number": "864-699-9863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL PROFESSIONAL OF SOUTH CAROLINA, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL PROFESSIONAL OF SOUTH CAROLINA, P.C.",
        "enumeration_date": "2012-08-27",
        "last_updated": "2012-08-27",
        "status": "A",
        "authorized_official_last_name": "HARDIEK",
        "authorized_official_first_name": "PAM",
        "authorized_official_title_or_position": "INSURANCE/CREDENTIALING",
        "authorized_official_telephone_number": "217-540-5100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Care of Boiling Springs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boiling Springs, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2012; 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.