Active NPI
Pageland Dentistry PA
- Public Health Dentistry
- Pageland, SC
National Provider Identifier
1689088676
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health Dentistry
- License
- 4435
- Legal business name
- PAGELAND DENTISTRY PA
- Practice address
- 124 S Pearl St
Pageland, SC 29728-2254 - Phone
- (843) 672-2403
- Fax
- (843) 672-3299
- NPI assigned
- Jun 17, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Anastasia V Voronina, DDS
- Title
- Owner/Dentist
- Phone
- (843) 672-2403
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health Dentistry | 1223D0001X | 4435 | SC | Primary |
Addresses
Primary practice location
124 S Pearl St
Pageland, SC 29728-2254
Mailing address
124 S Pearl St
Pageland, SC 29728-2254
Phone (843) 672-2403
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZX4435 | Medicaid | SC |
National Provider Directory
National Provider DirectoryLocations
124 S Pearl St
Pageland, SC 29728
Phone (843) 672-2403
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- General Practice Dentistry
- Pageland, SC
- NPI 1770769713
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402963200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1402963200000",
"number": "1689088676",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "124 S PEARL ST",
"city": "PAGELAND",
"state": "SC",
"postal_code": "297282254",
"telephone_number": "843-672-2403",
"fax_number": "843-672-3299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "124 S PEARL ST",
"city": "PAGELAND",
"state": "SC",
"postal_code": "297282254",
"telephone_number": "843-672-2403",
"fax_number": "843-672-3299"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PAGELAND DENTISTRY PA",
"organizational_subpart": "NO",
"enumeration_date": "2014-06-17",
"last_updated": "2014-06-17",
"status": "A",
"authorized_official_last_name": "VORONINA",
"authorized_official_first_name": "ANASTASIA",
"authorized_official_middle_name": "V",
"authorized_official_title_or_position": "OWNER/DENTIST",
"authorized_official_telephone_number": "843-672-2403",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "1223D0001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, Dental Public Health",
"state": "SC",
"license": "4435",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "ZX4435",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Pageland, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.