Progrin Dental of Five Forks, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

PROGRIN DENTAL OF FIVE FORKS, LLC

Practice address

2098 Woodruff Rd
Greenville, SC 29607-5939

Phone

(864) 254-6414

NPI assigned

May 8, 2018

Organization subpart

No

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

Authorized official

Name

Gregory Ayers

Title

Owner

Phone

(864) 561-7559

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1525737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525737600000",
    "number": "1801385554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 OLD BOILING SPRINGS RD STE A",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296504257",
            "telephone_number": "864-561-7559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2098 WOODRUFF RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296075939",
            "telephone_number": "864-254-6414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRIN DENTAL OF FIVE FORKS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-08",
        "last_updated": "2018-05-08",
        "status": "A",
        "authorized_official_last_name": "AYERS",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "864-561-7559"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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 May 8, 2018; 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.