Mauldin Square Dental, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

MAULDIN SQUARE DENTAL, LLC

Practice address

211 E Butler Rd Ste B3
Mauldin, SC 29662-2170

Phone

(864) 855-2788

NPI assigned

Jul 20, 2021

Organization subpart

No

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

Authorized official

Name

Angela Baker, RDH

Title

Operations Manager

Phone

(864) 855-2788

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.

• Sonia Kakkar, DDS

  • Dentist
  • Easley, SC
  • NPI 1346302049
  NPD

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

{
    "created_epoch": "1626739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626739200000",
    "number": "1841863628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 FLEETWOOD DR",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296402019",
            "telephone_number": "864-855-2788",
            "fax_number": "864-855-2789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 E BUTLER RD STE B3",
            "city": "MAULDIN",
            "state": "SC",
            "postal_code": "296622170",
            "telephone_number": "864-855-2788"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 Fleetwood Dr",
            "address_purpose": "LOCATION",
            "city": "Easley",
            "state": "SC",
            "postal_code": "296402019",
            "country_code": "US",
            "telephone_number": "864-855-2788",
            "fax_number": "864-855-2789",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MAULDIN SQUARE DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-20",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "864-855-2788",
        "authorized_official_credential": "RDH"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Stevenson Mahaffey, MSP, CCC-SLP
• Marley Wolfe Counseling Services
• Martin Pediatric Dentistry, LLC
• Brooke Mattison, LPC
• Mauldin Family Pharmacy Inc
• Maverick Smiles Orthodontics
• Maverick Smiles, LLC
• John Mark McCraw, DMD
• Logan Hawkins McCuen
• Shanelia McCullough

• Dental Clinic/Center in Mauldin, SC
• Providers in Mauldin, 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 Jul 20, 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.