NPIMap

Organization Active NPI

Sunset Periodontics, LLC

  • Periodontics
  • West Columbia, SC
National Provider Identifier
1598142341
Registry record updated Jun 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
826 Issued in SC
Legal business name
SUNSET PERIODONTICS, LLC
Practice address
159 Medical Cir
West Columbia, SC 29169-3655
Phone
(803) 794-7520
NPI assigned
Apr 30, 2015
Last updated
Jun 4, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2015

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

Authorized official

Name
Dr. Travis Wayne Mize, D.M.D., M.H.S.NPI 1265682686
Title
Owner
Phone
(317) 345-3113

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
Periodontics 1223P0300X 826 SC Primary

Addresses

Primary practice location

159 Medical Cir
West Columbia, SC 29169-3655

Mailing address

159 Medical Cir
West Columbia, SC 29169-3655
Phone (803) 794-7520

National Provider Directory

National Provider Directory

Locations

159 Medical Cir
West Columbia, SC 29169
Phone (803) 794-7520

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": "1430352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433376000000",
    "number": "1598142341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 MEDICAL CIR",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291693655",
            "telephone_number": "803-794-7520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 MEDICAL CIR",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291693655",
            "telephone_number": "803-794-7520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNSET PERIODONTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-30",
        "last_updated": "2015-06-04",
        "status": "A",
        "authorized_official_last_name": "MIZE",
        "authorized_official_first_name": "TRAVIS",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-345-3113",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D., M.H.S."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "SC",
            "license": "826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 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.