Active NPI
Emily Martin Ewoldt, DMD
- General Practice Dentistry
- Seneca, SC
National Provider Identifier
1669966198
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 9147
- Practice address
- 875 Old Clemson Hwy
Seneca, SC 29672-8060 - Phone
- (864) 654-5733
- NPI assigned
- Jun 18, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 9147 | SC | Primary |
Addresses
Primary practice location
875 Old Clemson Hwy
Seneca, SC 29672-8060
Mailing address
118 Folger St
Clemson, SC 29631-1304
Phone (864) 650-0090
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| John G McRoberts DMD PA | General Practice | Past | Accepting new patients |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529280000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634083200000",
"number": "1669966198",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "118 FOLGER ST",
"city": "CLEMSON",
"state": "SC",
"postal_code": "296311304",
"telephone_number": "864-650-0090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "875 OLD CLEMSON HWY",
"city": "SENECA",
"state": "SC",
"postal_code": "296728060",
"telephone_number": "864-654-5733"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EWOLDT",
"first_name": "EMILY",
"middle_name": "MARTIN",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-18",
"last_updated": "2021-10-13",
"certification_date": "2021-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "SC",
"license": "9147",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seneca, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.