Carolina Roots Dentistry LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

CAROLINA ROOTS DENTISTRY LLC

Practice address

9905 Calvin Hall Road
100
Indian Land, SC 29707

Phone

(864) 631-6644

NPI assigned

Jun 9, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Gerry George, DMD

Title

Dentist

Phone

(864) 631-6644

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1623196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623196800000",
    "number": "1750958666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2038 COUNTRY MANOR DR",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294667410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9905 CALVIN HALL ROAD",
            "address_2": "100",
            "city": "INDIAN LAND",
            "state": "SC",
            "postal_code": "29707",
            "telephone_number": "864-631-6644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA ROOTS DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-09",
        "last_updated": "2021-06-09",
        "certification_date": "2021-05-21",
        "status": "A",
        "authorized_official_last_name": "GEORGE",
        "authorized_official_first_name": "GERRY",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "864-631-6644",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caregivers of Carolina LLC
• Matthew Richard Carlisle, DMD
• Carolina Integrative Health Care LLC
• Carolina Orthopaedic Surgery Associates, PA
• Carolina Podiatry Group, Inc.
• Carolina Smile Dentistry, LLC
• Carolina Spine LLC
• Carolina Vision
• Carolinas Physicians Network Inc
• Carolinas Physicians Network Inc

• Dental Clinic/Center in Indian Land, SC
• Providers in Indian Land, SC by specialty
• Dental Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2021; 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.