Parkway Dentistry of Anderson, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3609 Issued in SC

Legal business name

PARKWAY DENTISTRY OF ANDERSON, LLC

Practice address

104 Montgomery Dr
Anderson, SC 29621-3334

Phone

(864) 225-3763

Fax

(864) 225-8486

NPI assigned

Jan 25, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Patrick Ryan Marcello, D.M.D.

Title

Owner

Phone

(864) 225-3763

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Royal Crest Centre for Advanced Dentistry Doing business as

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261526400000",
    "number": "1609922517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 MONTGOMERY DR",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296213334",
            "telephone_number": "864-225-3763",
            "fax_number": "864-225-8486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 MONTGOMERY DR",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296213334",
            "telephone_number": "864-225-3763",
            "fax_number": "864-225-8486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKWAY DENTISTRY OF ANDERSON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2009-12-23",
        "status": "A",
        "authorized_official_last_name": "MARCELLO",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "864-225-3763",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "3609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZA9525",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Royal Crest Centre for Advanced Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Paragon Skin & Surgery, PA
• Vaughn David Parfitt, OD
• Jeremy Parker, MD
• Jonathan David Parker, MD
• Sallie Parker
• Dineshkumar D Parmar, MD
• Carissa Burgess Parnell, MS, APRN, FNP-C
• Ruth Parnell, RN
• Savannah Kate Parnell, PTA
• Vicky Parnell, BSPT

• General Practice Dentistry in Anderson, SC
• Providers in Anderson, SC by specialty
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2009; 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.