Individual provider Active NPI

Virginia Fadeley Owens, DMD

  • General Practice Dentistry
  • West Columbia, SC
National Provider Identifier
1649535964
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8099 Issued in SC
Practice address
3308 Platt Springs Rd
West Columbia, SC 29170-2204
Phone
(803) 360-3816
NPI assigned
Jul 12, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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 8099 SC Primary

Addresses

Primary practice location

3308 Platt Springs Rd
West Columbia, SC 29170-2204

Mailing address

3308 Platt Springs Rd
West Columbia, SC 29170-2204
Phone (803) 360-3816

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
I20150730012975 SC Order and Referring Only - DentistPractitioner - Dentist 7911211222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8099SCMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1342051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1649535964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3308 PLATT SPRINGS RD",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291702204",
            "telephone_number": "803-360-3816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3308 PLATT SPRINGS RD",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291702204",
            "telephone_number": "803-360-3816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWENS",
        "first_name": "VIRGINIA",
        "middle_name": "FADELEY",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-12",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "8099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Columbia, SC

Sources for this page

Verify at the official NPI Registry.