Organization Active NPI

Healthy Smiles of Spartanburg

  • Voluntary or Charitable Agency
  • Spartanburg, SC
National Provider Identifier
1770755399
Registry record updated Mar 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Voluntary or Charitable AgencyTaxonomy code 251V00000X
Legal business name
HEALTHY SMILES OF SPARTANBURG
Practice address
800 Brisack Road
Spartanburg, SC 29303
Phone
(864) 592-4698
Fax
(864) 592-4697
NPI assigned
Mar 25, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2008

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

Authorized official

Name
Ms. Cynthia C Roddey
Title
Executive Director
Phone
(864) 592-4698

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Voluntary or Charitable Agency 251V00000X Primary

Addresses

Primary practice location

800 Brisack Road
Spartanburg, SC 29303

Mailing address

PO Box 1441
Spartanburg, SC 29304-1441
Phone (864) 592-4698

Other identifiers 1

IdentifierTypeStateIssuer
W01524SC1MedicaidSC

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1206403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206403200000",
    "number": "1770755399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1441",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293041441",
            "telephone_number": "864-592-4698",
            "fax_number": "864-592-4697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 BRISACK ROAD",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "29303",
            "telephone_number": "864-592-4698",
            "fax_number": "864-592-4697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY SMILES OF SPARTANBURG",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-25",
        "last_updated": "2008-03-25",
        "status": "A",
        "authorized_official_last_name": "RODDEY",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "864-592-4698",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "W01524SC1",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2008; 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.