NPIMap

Organization Active NPI

Midlands Pediatric Dentistry LLC

  • Pediatric Dentistry
  • Lexington, SC
National Provider Identifier
1841667037
Registry record updated Aug 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
3801 Issued in SC
Legal business name
MIDLANDS PEDIATRIC DENTISTRY LLC
Practice address
253 Cedarcrest Dr
Lexington, SC 29072-3812
Phone
(803) 951-7337
NPI assigned
Aug 24, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2015

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

Authorized official

Name
Dr. Robert Laforrest Shoun, DMDNPI 1306069299
Title
Dentist/Owner
Phone
(803) 348-8976

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
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 3801 SC Primary

Addresses

Primary practice location

253 Cedarcrest Dr
Lexington, SC 29072-3812

Mailing address

221 Springs CT
West Columbia, SC 29170-2474
Phone (803) 951-7337

National Provider Directory

National Provider Directory

Locations

253 Cedarcrest Dr
Lexington, SC 29072
Phone (803) 951-7337

Practitioners & affiliated clinicians

Practitioners 1

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": "1440374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440374400000",
    "number": "1841667037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 SPRINGS CT",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291702474",
            "telephone_number": "803-951-7337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "253 CEDARCREST DR",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290723812",
            "telephone_number": "803-951-7337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDLANDS PEDIATRIC DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-24",
        "last_updated": "2015-08-24",
        "status": "A",
        "authorized_official_last_name": "SHOUN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "LAFORREST",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "803-348-8976",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "SC",
            "license": "3801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2015; 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.