NPIMap

Organization Active NPI

Upstate Prosthodontics, L.L.C.

  • Prosthodontics
  • Greenville, SC
National Provider Identifier
1841365095
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
0361 Issued in SC
Legal business name
UPSTATE PROSTHODONTICS, L.L.C.
Practice address
321 Mills Ave
Greenville, SC 29605-4021
Phone
(864) 232-3882
Fax
(864) 240-7494
NPI assigned
Nov 22, 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. Donald Lee Ridgell, DMDNPI 1184975484
Title
Doctor
Phone
(864) 232-3882

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
ProsthodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0700X 0361 SC Primary

Addresses

Primary practice location

321 Mills Ave
Greenville, SC 29605-4021

Mailing address

321 Mills Ave
Greenville, SC 29605-4021
Phone (864) 232-3882

National Provider Directory

National Provider Directory

Locations

321 Mills Ave
Greenville, SC 29605
Phone (864) 232-3882

Practitioners & affiliated clinicians

Practitioners 2

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": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841365095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 MILLS AVE",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054021",
            "telephone_number": "864-232-3882",
            "fax_number": "864-240-7494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 MILLS AVE",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054021",
            "telephone_number": "864-232-3882",
            "fax_number": "864-240-7494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPSTATE PROSTHODONTICS, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RIDGELL",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "864-232-3882",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": "SC",
            "license": "0361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, 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.