NPIMap

Organization Active NPI

Dental Professionals of SC, PC

  • General Practice Dentistry
  • Lexington, SC
National Provider Identifier
1497166227
Registry record updated Jun 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL PROFESSIONALS OF SC, PC
Practice address
5551 Sunset Blvd
Lexington, SC 29072-9132
Phone
(803) 399-8829
NPI assigned
May 14, 2014
Organization subpart
Yes
Parent organization
DENTAL PROFESSIONALS OF SC, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 16, 2014

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

Authorized official

Name
Kendra Walker
Title
Credentialing Coordinator
Phone
(217) 540-8312

Specialties & licenses 1

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

Addresses

Primary practice location

5551 Sunset Blvd
Lexington, SC 29072-9132

Mailing address

5551 Sunset Blvd
Lexington, SC 29072-9132

Other names 1

  • Family Dental of Lexington Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dental Professional of South Carolina PC74 organizations share this tax ID, including this one
Part of
Dental Professional of South Carolina 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

5551 Sunset Blvd
Lexington, SC 29072
Phone (803) 399-8829

Practitioners & affiliated clinicians

Practitioners 1

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": "1400025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402876800000",
    "number": "1497166227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5551 SUNSET BLVD",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290729132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5551 SUNSET BLVD",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290729132",
            "telephone_number": "803-399-8829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL PROFESSIONALS OF SC, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL PROFESSIONALS OF SC, PC",
        "enumeration_date": "2014-05-14",
        "last_updated": "2014-06-16",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "KENDRA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-8312"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Dental of Lexington",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lexington, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2014; 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.