Organization Active NPI

Pendleton Neighborhood Dental, LLC

  • General Practice Dentistry
  • Pendleton, SC
National Provider Identifier
1689520140
Registry record updated Mar 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
PENDLETON NEIGHBORHOOD DENTAL, LLC
Practice address
137 Cotesworth St Unit E
Pendleton, SC 29670-9545
Phone
(714) 423-4436
NPI assigned
Mar 7, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2026

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

Authorized official

Name
Kerills Hossam Azer Habashi, DMDNPI 1992417182
Title
Dentist
Phone
(714) 423-4436

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

137 Cotesworth St Unit E
Pendleton, SC 29670-9545

Mailing address

137 Cotesworth St Unit E
Pendleton, SC 29670-9545

National Provider Directory

National Provider Directory

Locations

137 Cotesworth St
Unit E
Pendleton, SC 29670
Phone (714) 423-4436

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": "1772841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772841600000",
    "number": "1689520140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 COTESWORTH ST UNIT E",
            "city": "PENDLETON",
            "state": "SC",
            "postal_code": "296709545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 COTESWORTH ST UNIT E",
            "city": "PENDLETON",
            "state": "SC",
            "postal_code": "296709545",
            "telephone_number": "714-423-4436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENDLETON NEIGHBORHOOD DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-07",
        "last_updated": "2026-03-07",
        "certification_date": "2026-03-07",
        "status": "A",
        "authorized_official_last_name": "AZER HABASHI",
        "authorized_official_first_name": "KERILLS HOSSAM",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "714-423-4436",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pendleton, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2026; 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.