William J Boyd Jr., DMD
Individual provider Active NPI General Practice Dentistry · Travelers Rest, SC
NPI 1679003156 · NPPES record last updated Jan 15, 2025
Key facts
- NPI
- 1679003156
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 10943 (SC)
- Practice address
- 125 Botanical Cir
Travelers Rest, SC 29690-7112 - Phone
- (864) 836-3611
- NPI assigned
- Jun 15, 2017
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171102002879 | AZ | Order and Referring Only - Dentist |
5193081461 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9729 | AZ | MD | Dentist |
| 10943 | SC | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Dental Retreat LLC | General Practice | Current |
Accepting new patients |
| The Dental Retreat at Mountain Park | Past |
Accepting new patients | |
| Marketplace Smiles, LLP | General Practice | Past | Accepting new patients |
Locations
125 Botanical Cir
Travelers Rest, SC 29690
Phone (602) 502-4540
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 9729 | AZ | |
| General Practice Dentistry | 1223G0001X | 10943 | SC | Yes |
Addresses
Primary practice location
125 Botanical Cir
Travelers Rest, SC 29690-7112
Mailing address
125 Botanical Cir
Travelers Rest, SC 29690-7112
Phone (864) 836-3611
Other providers in Travelers Rest, SC
- Sarah Anna Blum-Sheller
- Hannah Moore Blume
- Bon Secours Medical Group Greenville Specialty Care LLC
- Olivia Booth
- Megan McNulty Bowers
- Brett Russell Physical Therapy and Fitness LLC
- Francis William Briceland II
- Bridgestep, LLC
- Glenn T Brothers
- Miranda Burgess Brunson
All providers in Travelers Rest, SC · General Practice Dentistry in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 15, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.