Individual provider Active NPI

Robert Kenny Gildner, DMD

  • General Practice Dentistry
  • Lexington, SC
National Provider Identifier
1609124767
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8527 Issued in SC
Practice address
602 E Main St Ste E
Lexington, SC 29072-3730
Phone
(803) 957-2440
NPI assigned
Aug 21, 2012
Last updated
Apr 16, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 8527 SC Primary

Addresses

Primary practice location

602 E Main St Ste E
Lexington, SC 29072-3730

Mailing address

602 E Main St Ste E
Lexington, SC 29072-3730
Phone (803) 957-2440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161024001281 SC Order and Referring Only - DentistPractitioner - Dentist 1254619406

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8527SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Gildner Family Dentistry LLC General Practice CurrentSince Apr 15, 2017 Accepting new patients

Locations

602 E Main St
Ste E
Lexington, SC 29072
Phone (803) 622-5173

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1345507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1609124767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 E MAIN ST STE E",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290723730",
            "telephone_number": "803-957-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 E MAIN ST STE E",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290723730",
            "telephone_number": "803-957-2440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILDNER",
        "first_name": "ROBERT",
        "middle_name": "KENNY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-21",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "8527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, SC

Sources for this page

Verify at the official NPI Registry.