Restorative Arts Dental PA

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

RESTORATIVE ARTS DENTAL PA

Practice address

669B W Wesmark Blvd
Sumter, SC 29150-1900

Phone

(803) 905-3567

NPI assigned

Mar 30, 2023

Organization subpart

No

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

Authorized official

Name

Grover RabonNPI 1922164706

Title

Owner

Phone

(803) 905-3567

Specialties & licenses 1

Addresses

Tax ID family

Restorative Arts Dental PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Restorative Arts Dental PA

  • Public Health Dentistry
  • Sumter, SC
  • NPI 1043962186
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Grover Edens Rabon, DMD

  • General Practice Dentistry
  • Sumter, SC
  • NPI 1922164706
  NPD (past) Authorized official
• Matthew Kirkland, DMD

  • Dentist
  • Sumter, SC
  • NPI 1578409231
  NPD (past)

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

{
    "created_epoch": "1680134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680134400000",
    "number": "1851095053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "669B W WESMARK BLVD",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291501900",
            "telephone_number": "803-905-3567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "669B W WESMARK BLVD",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291501900",
            "telephone_number": "803-905-3567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORATIVE ARTS DENTAL PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-30",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A",
        "authorized_official_last_name": "RABON",
        "authorized_official_first_name": "GROVER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-905-3567"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly W Reisenauer, P.A.
• Jordan Thomas Reizer I, DC
• Reliable Medical Equipment of South Carolina, LLC
• Renewed Image Youth & Family Services, LLC
• Restorative Arts Dental PA
• Andrew J. Reynolds, MD
• Edward Roger Reynolds Jr., PAC
• Jeremy Allen Rhodes, DO
• Russell David Rich, M.A.
• Rhonda Kay Richardson-Windham, RN, BSN

• Durable Medical Equipment & Medical Supplies in Sumter, SC
• Providers in Sumter, SC by specialty
• Durable Medical Equipment & Medical Supplies in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2023; 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.