Active NPI
Thomas Gunnar Branham, DMD
- Dentist
- Camden, SC
National Provider Identifier
1700570249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 10513
- Practice address
- 400 Dicey Ford Rd
Camden, SC 29020-2431 - Phone
- (803) 432-4202
- NPI assigned
- Jun 7, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 10513 | SC | Primary |
Addresses
Primary practice location
400 Dicey Ford Rd
Camden, SC 29020-2431
Mailing address
400 Dicey Ford Rd
Camden, SC 29020-2431
Phone (803) 432-4202
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10513 | SC | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dental Health Professionals of South Carolina, PC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Camden, SC
- NPI 1629448055
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1686096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686096000000",
"number": "1700570249",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 DICEY FORD RD",
"city": "CAMDEN",
"state": "SC",
"postal_code": "290202431",
"telephone_number": "803-432-4202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 DICEY FORD RD",
"city": "CAMDEN",
"state": "SC",
"postal_code": "290202431",
"telephone_number": "803-432-4202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRANHAM",
"first_name": "THOMAS",
"middle_name": "GUNNAR",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-06-07",
"last_updated": "2023-06-07",
"certification_date": "2023-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "SC",
"license": "10513",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Camden, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.