NPIMap

Organization Active NPI

Archdale Family Dentistry Associates, LLC

  • General Practice Dentistry
  • North Charleston, SC
National Provider Identifier
1609316454
Registry record updated Feb 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6959 Issued in SC
Legal business name
ARCHDALE FAMILY DENTISTRY ASSOCIATES, LLC
Practice address
5306 Parkshire Way
North Charleston, SC 29418-2000
Phone
(843) 552-1600
Fax
(843) 552-0049
NPI assigned
Feb 27, 2017
Last updated
Feb 27, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2017

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

Authorized official

Name
Mrs. Colleen P. Condrey
Title
Office Manager
Phone
(843) 552-1600

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6959 SC Primary
General Practice Dentistry 1223G0001X 2785 SC

Addresses

Primary practice location

5306 Parkshire Way
North Charleston, SC 29418-2000

Mailing address

5306 Parkshire Way
North Charleston, SC 29418-2000
Phone (843) 552-1600

National Provider Directory

National Provider Directory

Locations

5306 Parkshire Way
North Charleston, SC 29418
Phone (843) 552-1600

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": "1488153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488153600000",
    "number": "1609316454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5306 PARKSHIRE WAY",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294182000",
            "telephone_number": "843-552-1600",
            "fax_number": "843-552-0049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5306 PARKSHIRE WAY",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294182000",
            "telephone_number": "843-552-1600",
            "fax_number": "843-552-0049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARCHDALE FAMILY DENTISTRY ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-27",
        "last_updated": "2017-02-27",
        "status": "A",
        "authorized_official_last_name": "CONDREY",
        "authorized_official_first_name": "COLLEEN",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "843-552-1600",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "6959",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "2785",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2017; 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.