NPIMap

Organization Active NPI

Jim Nasim DMD PA

  • General Practice Dentistry
  • Spartanburg, SC
National Provider Identifier
1720246325
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
JIM NASIM DMD PA
Doing business as
Hall Street Family Dental
Practice address
162 Hall St
Spartanburg, SC 29302-1524
Phone
(864) 582-5915
Fax
(864) 582-1076
NPI assigned
May 30, 2008
Organization subpart
Yes
Parent organization
JIM NASIM DMD PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 4, 2024

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

Authorized official

Name
Jenni Tomlinson
Title
Credentialing Specialist
Phone
(864) 582-5915

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary
Dental Clinic/Center 261QD0000X 2881 SC

Addresses

Primary practice location

162 Hall St
Spartanburg, SC 29302-1524

Mailing address

162 Hall St
Spartanburg, SC 29302-1524
Phone (864) 582-5915

Other identifiers 1

IdentifierTypeStateIssuer
ZA9703MedicaidSC

Other names 1

  • Hall Street Family Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Jim Nasim DMD PA5 organizations share this tax ID, including this one
Part of
Jim Nasim DMD PA

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

162 Hall St
Spartanburg, SC 29302
Phone (864) 582-5915

Practitioners & affiliated clinicians

Practitioners 2

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": "1212105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709510400000",
    "number": "1720246325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "162 HALL ST",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293021524",
            "telephone_number": "864-582-5915",
            "fax_number": "864-582-1076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162 HALL ST",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293021524",
            "telephone_number": "864-582-5915",
            "fax_number": "864-582-1076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JIM NASIM DMD PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JIM NASIM DMD PA",
        "enumeration_date": "2008-05-30",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A",
        "authorized_official_last_name": "TOMLINSON",
        "authorized_official_first_name": "JENNI",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "864-582-5915"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "SC",
            "license": "2881",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZA9703",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hall Street Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Spartanburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2024; 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.