Progrin Dental of Woodruff LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

PROGRIN DENTAL OF WOODRUFF LLC

Doing business as

ProGrin Dental

Practice address

420 S Main St
Woodruff, SC 29388-2117

Phone

(864) 834-8001

Fax

(864) 476-0439

NPI assigned

Jun 19, 2012

Last updated

Jun 19, 2012By 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

Mr. Brent Allen Ayers

Title

President

Phone

(864) 561-7559

Specialties & licenses 1

Addresses

Other names 1

• ProGrin Dental Doing business as

Locations

Practitioners 1

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.

• Kaley Ellyn Peek, D.M.D.

  • General Practice Dentistry
  • Woodruff, SC
  • NPI 1386084184
  NPD (past)

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

{
    "created_epoch": "1340064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340064000000",
    "number": "1730442310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 S MAIN ST",
            "city": "WOODRUFF",
            "state": "SC",
            "postal_code": "293882117",
            "telephone_number": "864-834-8001",
            "fax_number": "864-476-0439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 S MAIN ST",
            "city": "WOODRUFF",
            "state": "SC",
            "postal_code": "293882117",
            "telephone_number": "864-834-8001",
            "fax_number": "864-476-0439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRIN DENTAL OF WOODRUFF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-19",
        "last_updated": "2012-06-19",
        "status": "A",
        "authorized_official_last_name": "AYERS",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "864-561-7559",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ProGrin Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Piedmont Pediatrics LLC
• Premise Health of South Carolina Medical PC (Industrial Health Services - Battery Plant)
• Primary Spine and Injury Corp
• Prime Dental of Woodruff
• Ashley W Prince
• Project Hope Foundation (Hope Reach)
• Project Hope Foundation (Hope Reach)
• Project Hope Foundation (Hopereach)
• Regenesis Organization Community Health Center (Regenesis Health Care Pharmacy #5)
• Regenesis Organization Community Health Center (Woodruff Medical Center)

• General Practice Dentistry in Woodruff, SC
• Providers in Woodruff, 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 19, 2012; 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.