Active NPI
Washington Ray Jr., DDS
- Dentist
- Sumter, SC
National Provider Identifier
1740396803
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2238
- Practice address
- 625 Constitution Dr
Sumter, SC 29154-8190 - Phone
- (803) 773-5413
- NPI assigned
- Aug 22, 2006
- 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 | 2238 | SC | Primary |
Addresses
Primary practice location
625 Constitution Dr
Sumter, SC 29154-8190
Mailing address
625 Constitution Dr
Sumter, SC 29154-8190
Phone (803) 773-5413
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 239742 | Medicaid | SC |
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 |
|---|---|---|---|
| 2238 | SC | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Omni Dental of Sumter LLC | Past | Accepting new patients | |
| Arian L. Ray DDS PA | Past | Accepting new patients |
Organizations & group practices 2
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
- Sumter, SC
- NPI 1225363336
-
- Dental Clinic/Center
- Sumter, SC
- NPI 1275356289
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1460937600000",
"number": "1740396803",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "625 CONSTITUTION DR",
"city": "SUMTER",
"state": "SC",
"postal_code": "291548190",
"telephone_number": "803-773-5413"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "625 CONSTITUTION DR",
"city": "SUMTER",
"state": "SC",
"postal_code": "291548190",
"telephone_number": "803-773-5413"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAY",
"first_name": "WASHINGTON",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-22",
"last_updated": "2016-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "SC",
"license": "2238",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "239742",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sumter, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.