Solomon Kids Pediatric Dentistry Knightsville LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

8526 Issued in SC

Legal business name

SOLOMON KIDS PEDIATRIC DENTISTRY KNIGHTSVILLE LLC

Practice address

491 W Butternut Rd
Summerville, SC 29483-5507

Phone

(843) 871-0842

NPI assigned

Jul 20, 2017

Organization subpart

No

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

Authorized official

Name

Mrs. Angela Marie Bazzle

Title

Operation Manager

Phone

(843) 871-0842

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1500508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1500508800000",
    "number": "1770006876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1971 N MAIN ST",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294867820",
            "telephone_number": "843-871-0842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "491 W BUTTERNUT RD",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294835507",
            "telephone_number": "843-871-0842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOLOMON KIDS PEDIATRIC DENTISTRY KNIGHTSVILLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-20",
        "last_updated": "2017-07-20",
        "status": "A",
        "authorized_official_last_name": "BAZZLE",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OPERATION MANAGER",
        "authorized_official_telephone_number": "843-871-0842",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "SC",
            "license": "8526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZX8526",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZX8227",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Soaring Minds Evaluations and Support
• Sober Incorporated
• Taylor R Solarek
• Solomon Dental Sedations LLC
• Solomon Dental Sedations LLC
• Solomon Orthodontics LLC
• Alwyn Frederick Solomon, DMD
• Jason Eric Solomon, D.M.D
• Solutions 4 Life
• Whitney Esther Sommers, M.D.

• Pediatric Dentistry in Summerville, SC
• Providers in Summerville, SC by specialty
• Pediatric Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2017; 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.