Spark Dental SC LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SPARK DENTAL SC LLC

Doing business as

Oak Tree Pediatric Dentistry

Practice address

415 Farrs Bridge Rd
Greenville, SC 29617-1858

Phone

(864) 232-6800

NPI assigned

Jul 29, 2026

Last updated

Jul 29, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sherrie Edmondson

Title

Director of Credentialing

Phone

(629) 666-8612

Specialties & licenses 1

Addresses

Other names 1

• Oak Tree Pediatric Dentistry Doing business as

Locations

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

{
    "created_epoch": "1785283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785283200000",
    "number": "1780506881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 831175",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191821175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 FARRS BRIDGE RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296171858",
            "telephone_number": "864-232-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPARK DENTAL SC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-29",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A",
        "authorized_official_last_name": "EDMONDSON",
        "authorized_official_first_name": "SHERRIE",
        "authorized_official_title_or_position": "DIRECTOR OF CREDENTIALING",
        "authorized_official_telephone_number": "629-666-8612"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oak Tree Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Beverly Spaar, PTA
• Gregorio O'Neill Spagnolo, PA-C
• Shelley M. Spang, CRNA
• Belle Spangle
• Stephanie Ann Spanioli, NP
• Spark Orthodontics SC LLC (Oak Tree Orthodontics)
• Spark Therapy Group LLC
• Rida Sparks-Freemont, APRN, FNP-BC
• Clarissa Sparks, RBT
• Kaelyn Brett Sparks, APRN

• General Practice Dentistry in Greenville, SC
• Providers in Greenville, SC by specialty
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2026; 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.