Organization Active NPI

Pageland Dentistry PA

  • Public Health Dentistry
  • Pageland, SC
National Provider Identifier
1689088676
Registry record updated Jun 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health DentistryTaxonomy code 1223D0001X
License
4435 Issued in SC
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

Updated by the provider on Jun 17, 2014

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

Authorized official

Name
Mrs. Anastasia V Voronina, DDSNPI 1770769713
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)CodeLicenseStatePrimary
Public Health DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
ZX4435MedicaidSC

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.