NPIMap

Organization Active NPI

Palmetto Family and Cosmetic Dentistry LLC

  • Dental Clinic/Center
  • Sumter, SC
National Provider Identifier
1841687241
Registry record updated Aug 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
4327 Issued in SC
Legal business name
PALMETTO FAMILY AND COSMETIC DENTISTRY LLC
Practice address
434 N Guignard Drive
Sumter, SC 29150-4748
Phone
(803) 773-5411
Fax
(803) 773-8231
NPI assigned
Apr 23, 2015
Organization subpart
Yes
Parent organization
PALMETTO FAMILY AND COSMETIC DENTISTRY LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 9, 2021

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

Authorized official

Name
Dr. Thaddeus H Vincent Jr., D.M.D.NPI 1225232788
Title
Dentist/Owner
Phone
(803) 773-5411

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
Dental Clinic/Center 261QD0000X 4327 SC Primary

Addresses

Primary practice location

434 N Guignard Drive
Sumter, SC 29150-4748

Mailing address

2590 Tahoe Dr
Sumter, SC 29150-1860
Phone (803) 773-5411

Other names 1

  • Palmetto Family and Cosmetic Dentistry Former legal business name

National Provider Directory

National Provider Directory
Part of
Palmetto Family and Cosmetic Dentistry LLC

Locations

2590 Tahoe Dr
Sumter, SC 29150
Phone (803) 469-3555

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 3

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": "1429747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628467200000",
    "number": "1841687241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2590 TAHOE DR",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291501860",
            "telephone_number": "803-773-5411",
            "fax_number": "803-773-8231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "434 N GUIGNARD DRIVE",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291504748",
            "telephone_number": "803-773-5411",
            "fax_number": "803-773-8231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO FAMILY AND COSMETIC DENTISTRY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PALMETTO FAMILY AND COSMETIC DENTISTRY LLC",
        "enumeration_date": "2015-04-23",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-09",
        "status": "A",
        "authorized_official_last_name": "VINCENT",
        "authorized_official_first_name": "THADDEUS",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "803-773-5411",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "SC",
            "license": "4327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Palmetto Family and Cosmetic Dentistry",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Palmetto Family and Cosmetic Dentistry",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Sumter, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2021; 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.