Dental Health Professionals of South Carolina, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

DENTAL HEALTH PROFESSIONALS OF SOUTH CAROLINA, PC

Doing business as

Dental Care of Camden

Practice address

400 Dicey Ford Rd
Camden, SC 29020

Phone

(803) 432-4202

Fax

(803) 432-4203

NPI assigned

Sep 28, 2015

Last updated

Jun 16, 2018By the provider in NPPES

Organization subpart

Yes

Parent organization

DENTAL HEALTH PROFESSIONALS OF SOUTH CAROLINA, PCAs reported in NPPES

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

Authorized official

Name

Kendra Walker

Title

Enrollment Team Lead

Phone

(217) 540-8513

Specialties & licenses 1

Addresses

Other names 2

• Dental Care of Camden Doing business as
• Dental Professionals of South Carolina, P.C. Former legal business name

Part of

Dental Health Professionals of South Carolina PC

Locations

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.

• Thomas Gunnar Branham, DMD

  • Dentist
  • Camden, SC
  • NPI 1700570249
  NPD (past)
• Kenneth W. Carson, DDS, PA

  • General Practice Dentistry
  • Camden, SC
  • NPI 1881627776
  NPD (past)

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

{
    "created_epoch": "1443398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1629448055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 DICEY FORD RD",
            "city": "CAMDEN",
            "state": "SC",
            "postal_code": "290202431",
            "telephone_number": "803-432-4202",
            "fax_number": "803-432-4203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 DICEY FORD RD",
            "city": "CAMDEN",
            "state": "SC",
            "postal_code": "29020",
            "telephone_number": "803-432-4202",
            "fax_number": "803-432-4203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL HEALTH PROFESSIONALS OF SOUTH CAROLINA, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL HEALTH PROFESSIONALS OF SOUTH CAROLINA, PC",
        "enumeration_date": "2015-09-28",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "KENDRA",
        "authorized_official_title_or_position": "ENROLLMENT TEAM LEAD",
        "authorized_official_telephone_number": "217-540-8513"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Care of Camden",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dental Professionals of South Carolina, P.C.",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Dental Professionals of South Carolina, P.C.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Kaydrell Davis
• Robert B Davis, PHARMD, MS
• Robert G. Dawkins Jr., M.D.
• Madeline Phae Dean, PHARMD
• Vincent J Degenhart, MD
• Christina Marie Derrick, LMFT
• Lindsay Amaya Deshields
• Tracey A Desjadon
• Elizabeth Diller, MA
• Patricia H Dillman, LPC

• General Practice Dentistry in Camden, SC
• Providers in Camden, 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 Jun 16, 2018; 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.