Stephen Parks, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8491 Issued in SC

Practice address

100 Professional CT
Mauldin, SC 29662-3257

Phone

(864) 288-4515

Fax

(501) 676-5147

NPI assigned

Jun 17, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Parks Family Dental

  • Dental Clinic/Center
  • Mauldin, SC
  • NPI 1659865905
  NPD Authorized official
• Smith Family Dentistry

  • General Practice Dentistry
  • Mauldin, SC
  • NPI 1144342296
  NPD (past)

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

{
    "created_epoch": "1308268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1790070738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PROFESSIONAL CT",
            "city": "MAULDIN",
            "state": "SC",
            "postal_code": "296623257",
            "telephone_number": "864-288-4515",
            "fax_number": "864-288-4992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PROFESSIONAL CT",
            "city": "MAULDIN",
            "state": "SC",
            "postal_code": "296623257",
            "telephone_number": "864-288-4515",
            "fax_number": "501-676-5147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKS",
        "first_name": "STEPHEN",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-17",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "8491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph F Paradise, DMD
• Jihyun Park
• Kimberly Gaston Parker, NP
• Parks Family Dental
• Ashley Cerone Parks, M.D.
• Sarah Prickett Pate
• Jeenal Patel, PHARM D.
• Pathways Counseling Center
• Zharia Payne
• Angela Rose Peightal, PHARMD

• General Practice Dentistry in Mauldin, SC
• Providers in Mauldin, 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 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.