Active NPI
Parks Burton Alexander, DMD
- General Practice Dentistry
- Greenville, SC
National Provider Identifier
1851374128
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 4025
- Practice address
- 114 Laurens Rd Ste a
Greenville, SC 29607-1826 - Phone
- (864) 336-8478
- Fax
- (864) 509-1514
- NPI assigned
- Nov 21, 2005
- Last updated
- Jun 4, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 4025 | SC | Primary |
Addresses
Primary practice location
114 Laurens Rd Ste a
Greenville, SC 29607-1826
Mailing address
PO Box 799
Simpsonville, SC 29681-0799
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1783199 | Other | SC | UNITED CONCORDIA INSUR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4025 | SC | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grinville Dentistry LLC | Current | Accepting new patients | |
| Simpsonville Dental Associates PA | General Practice | Past | Accepting new patients |
Locations
114 Laurens Rd
Ste A
Greenville, SC 29607
Phone (864) 336-8478
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Practice Dentistry
- Simpsonville, SC
- NPI 1407847213
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622764800000",
"number": "1851374128",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 799",
"city": "SIMPSONVILLE",
"state": "SC",
"postal_code": "296810799"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "114 LAURENS RD STE A",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296071826",
"telephone_number": "864-336-8478",
"fax_number": "864-509-1514"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALEXANDER",
"first_name": "PARKS",
"middle_name": "BURTON",
"name_prefix": "Mr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-21",
"last_updated": "2021-06-04",
"certification_date": "2021-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "SC",
"license": "4025",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA INSUR",
"identifier": "1783199",
"state": "SC"
}
],
"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 Jun 4, 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.