NPIMap

Organization Active NPI

Wild Smiles White Knoll Family Dentistry, LLC

  • Pediatric Dentistry
  • Lexington, SC
National Provider Identifier
1730415092
Registry record updated Oct 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
SC3351 Issued in SC
Legal business name
WILD SMILES WHITE KNOLL FAMILY DENTISTRY, LLC
Practice address
1767 S Lake Dr
Suite # a
Lexington, SC 29073-6734
Phone
(803) 356-1606
Fax
(803) 359-7542
NPI assigned
Oct 21, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2009

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

Authorized official

Name
Dr. Gunjit Rick Singh, D.M.D
Title
Owner
Phone
(803) 356-1606

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X SC3864 SC
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X SC3351 SC Primary
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X SC3801 SC

Addresses

Primary practice location

1767 S Lake Dr
Suite # a
Lexington, SC 29073-6734

Mailing address

1767 S Lake Dr
Suite # a
Lexington, SC 29073-6734
Phone (803) 356-1606

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1256083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256083200000",
    "number": "1730415092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1767 S LAKE DR",
            "address_2": "SUITE # A",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290736734",
            "telephone_number": "803-356-1606",
            "fax_number": "803-359-7542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1767 S LAKE DR",
            "address_2": "SUITE # A",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290736734",
            "telephone_number": "803-356-1606",
            "fax_number": "803-359-7542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILD SMILES WHITE KNOLL FAMILY DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-21",
        "last_updated": "2009-10-21",
        "status": "A",
        "authorized_official_last_name": "SINGH",
        "authorized_official_first_name": "GUNJIT",
        "authorized_official_middle_name": "RICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-356-1606",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "SC3864",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "SC",
            "license": "SC3351",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "SC",
            "license": "SC3801",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2009; 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.