NPIMap

Organization Active NPI

Dental Professionals of South Carolina, P.C.

Doing business as Prestwood Complete Dental Care

  • General Practice Dentistry
  • Hartsville, SC
National Provider Identifier
1740617646
Registry record updated Oct 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL PROFESSIONALS OF SOUTH CAROLINA, P.C.
Doing business as
Prestwood Complete Dental Care
Practice address
214 W Home Ave
Hartsville, SC 29550-4126
Phone
(843) 332-1331
Fax
(843) 857-9359
NPI assigned
Oct 9, 2013
Last updated
Oct 9, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
DENTAL PROFESSIONALS OF SOUTH CAROLINA, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 9, 2013

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

Authorized official

Name
Kim Wilson
Title
Cred. Supervisor
Phone
(217) 540-5170

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X Primary

Addresses

Primary practice location

214 W Home Ave
Hartsville, SC 29550-4126

Mailing address

214 W Home Ave
Hartsville, SC 29550-4126
Phone (843) 332-1331

Other names 1

  • Prestwood Complete Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dental Professional of SC74 organizations share this tax ID, including this one
Part of
Dental Professional of SC

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1381276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381276800000",
    "number": "1740617646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 W HOME AVE",
            "city": "HARTSVILLE",
            "state": "SC",
            "postal_code": "295504126",
            "telephone_number": "843-332-1331",
            "fax_number": "843-857-9359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 W HOME AVE",
            "city": "HARTSVILLE",
            "state": "SC",
            "postal_code": "295504126",
            "telephone_number": "843-332-1331",
            "fax_number": "843-857-9359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL PROFESSIONALS OF SOUTH CAROLINA, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL PROFESSIONALS OF SOUTH CAROLINA, P.C.",
        "enumeration_date": "2013-10-09",
        "last_updated": "2013-10-09",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "CRED. SUPERVISOR",
        "authorized_official_telephone_number": "217-540-5170"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prestwood Complete Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hartsville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2013; 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.