Sunnyside Family Dentistry LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

7101 Issued in SC

Legal business name

SUNNYSIDE FAMILY DENTISTRY LLC

Practice address

1500 W Main St Unit 110
Laurens, SC 29360-3767

Phone

(864) 715-2227

NPI assigned

May 30, 2017

Last updated

May 30, 2017By 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

Chika Agu, DDSNPI 1962713602

Title

Ceo

Phone

(864) 715-2227

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Chika N Agu, DDS

  • Dentist
  • Laurens, SC
  • NPI 1962713602
  NPD Authorized official

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

{
    "created_epoch": "1496102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1496102400000",
    "number": "1821526294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 YOUNG HARRIS DR",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296818115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 W MAIN ST UNIT 110",
            "city": "LAURENS",
            "state": "SC",
            "postal_code": "293603767",
            "telephone_number": "864-715-2227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNNYSIDE FAMILY DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-30",
        "last_updated": "2017-05-30",
        "status": "A",
        "authorized_official_last_name": "AGU",
        "authorized_official_first_name": "CHIKA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "864-715-2227",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "SC",
            "license": "7101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Ledford Strickland, APRN, FNP-C
• Candace L Strickland, PHARMD
• Heather Strickland, COTA/L
• Alicia Sullivan
• Carolyn Yvonne Sullivan
• Supplemental Health Care
• Bradley Tatko, DO
• Martha Wessinger Taylor, REGISTERED PHARMACIS
• Sarah Anne Taylor, OTR/L
• Cherlyn Thacker

• Dental Clinic/Center in Laurens, SC
• Providers in Laurens, SC by specialty
• Dental Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2017; 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.