NPIMap

Organization Active NPI

John C Cosby Jr DMD PA

  • General Practice Dentistry
  • Blythewood, SC
National Provider Identifier
1851559629
Registry record updated May 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
SC1677 Issued in SC
Legal business name
JOHN C COSBY JR DMD PA
Doing business as
Blythwood Village Dental Associates
Practice address
745 University Village Drive
Blythewood, SC 29016
Phone
(803) 754-9160
Fax
(803) 754-9162
NPI assigned
May 29, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2008

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

Authorized official

Name
Mr. John C Cosby Jr., DMDNPI 1558451070
Title
Owner President
Phone
(803) 754-9160

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X SC1677 SC Primary

Addresses

Primary practice location

745 University Village Drive
Blythewood, SC 29016

Mailing address

PO Box 969
Blythewood, SC 29016
Phone (803) 754-9160

Other names 1

  • Blythwood Village Dental Associates Doing business as

National Provider Directory

National Provider Directory

Locations

745 University Village Dr
Blythewood, SC 29016
Phone (803) 754-9160

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": "1212019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212019200000",
    "number": "1851559629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 969",
            "city": "BLYTHEWOOD",
            "state": "SC",
            "postal_code": "29016",
            "telephone_number": "803-754-9160",
            "fax_number": "803-754-9162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 UNIVERSITY VILLAGE DRIVE",
            "city": "BLYTHEWOOD",
            "state": "SC",
            "postal_code": "29016",
            "telephone_number": "803-754-9160",
            "fax_number": "803-754-9162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN C COSBY JR DMD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-29",
        "last_updated": "2008-05-29",
        "status": "A",
        "authorized_official_last_name": "COSBY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "803-754-9160",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "SC1677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blythwood Village Dental Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Blythewood, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2008; 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.