NPIMap

Organization Active NPI

Palmetto Dental Health Associates PA

  • Dentist
  • McColl, SC
National Provider Identifier
1821077751
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
3114 Issued in SC
Legal business name
PALMETTO DENTAL HEALTH ASSOCIATES PA
Practice address
103 East Tatum Avenue
McColl, SC 29570-2323
Phone
(843) 523-5291
Fax
(843) 523-9714
NPI assigned
Jan 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Kevin Allen Jasinski, DMDNPI 1982680609
Title
Co Owner Dentist
Phone
(843) 523-5291

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 3114 SC Primary

Addresses

Primary practice location

103 East Tatum Avenue
McColl, SC 29570-2323

Mailing address

103 East Tatum Avenue
McColl, SC 29570-2323
Phone (843) 523-5291

Other identifiers 1

IdentifierTypeStateIssuer
ZA9934MedicaidSC

National Provider Directory

National Provider Directory

Locations

103 E Tatum Ave
Mc Coll, SC 29570
Phone (843) 523-5291

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1821077751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 EAST TATUM AVENUE",
            "city": "MCCOLL",
            "state": "SC",
            "postal_code": "295702323",
            "telephone_number": "843-523-5291",
            "fax_number": "843-523-9714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 EAST TATUM AVENUE",
            "city": "MCCOLL",
            "state": "SC",
            "postal_code": "295702323",
            "telephone_number": "843-523-5291",
            "fax_number": "843-523-9714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO DENTAL HEALTH ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JASINSKI",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "CO OWNER DENTIST",
        "authorized_official_telephone_number": "843-523-5291",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "SC",
            "license": "3114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZA9934",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McColl, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.