Magnolia Family Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MAGNOLIA FAMILY DENTAL LLC

Practice address

2015 2ND Ave Ste 201
Summerville, SC 29486-7889

Phone

(516) 521-3012

NPI assigned

Jan 28, 2021

Last updated

Jun 27, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Matthew Ryan Sperber, DDSNPI 1710482773

Title

Owner

Phone

(843) 900-4428

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Matthew Ryan Sperber, DDS

  • General Practice Dentistry
  • Summerville, SC
  • NPI 1710482773
  NPD Authorized official
• Michael Dudleck, DMD

  • General Practice Dentistry
  • Summerville, SC
  • NPI 1881262889
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1611792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624752000000",
    "number": "1699366062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 2ND AVE STE 201",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294867889",
            "telephone_number": "843-900-4428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 2ND AVE STE 201",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294867889",
            "telephone_number": "516-521-3012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA FAMILY DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-28",
        "last_updated": "2021-06-27",
        "certification_date": "2021-06-27",
        "status": "A",
        "authorized_official_last_name": "SPERBER",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-900-4428",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.magnoliafamilydentalsc.com",
            "affiliation": "N",
            "address_1": "2015 2nd Ave Ste 201",
            "city": "Summerville",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294867889",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bernadette Payne Macleod, CPNP
• Patricia F. Maderson, LISW
• Magnolia Children's Therapy
• Magnolia Counseling
• Magnolia Endocrinology, LLC
• Magnolia Mental Health, LLC
• Magnolia Speech and Language, LLC
• Bernice Magwood
• Thomas Maino, M.D.
• Brittany Latasha Major, APRN,FNP-BC

• General Practice Dentistry in Summerville, SC
• Providers in Summerville, SC by specialty
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 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.

Verify at the official NPI Registry.