Palmetto Rainbow Dental Group LLC

Primary specialty

DentistTaxonomy code 122300000X

License

# 2226 Issued in SC

Legal business name

PALMETTO RAINBOW DENTAL GROUP LLC

Practice address

922 Wappoo Rd
Charleston, SC 29407-5957

Phone

(843) 763-8755

Fax

(843) 763-8755

NPI assigned

Mar 25, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Leonard E. Davis, D.D.S.

Title

Managing Parnter

Phone

(843) 763-8755

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1301011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301011200000",
    "number": "1720387004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "922 WAPPOO RD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294075957",
            "telephone_number": "843-763-8755",
            "fax_number": "843-763-8755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "922 WAPPOO RD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294075957",
            "telephone_number": "843-763-8755",
            "fax_number": "843-763-8755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO RAINBOW DENTAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-25",
        "last_updated": "2011-03-25",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "LEONARD",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "MANAGING PARNTER",
        "authorized_official_telephone_number": "843-763-8755",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "SC",
            "license": "# 2226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Palmetto State Pharmaceuticals Inc
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• Dentist in Charleston, SC
• Providers in Charleston, SC by specialty
• Dentist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2011; 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.