Alexis Collins Childrens Dentistry

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

4507 Issued in SC

Legal business name

ALEXIS COLLINS CHILDRENS DENTISTRY

Practice address

392 Saint Andrews Rd
Columbia, SC 29210-4427

Phone

(803) 772-7302

Fax

(803) 772-7353

NPI assigned

Jan 17, 2012

Organization subpart

No

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

Authorized official

Name

Alexis CollinsNPI 1003062753

Title

Owner

Phone

(803) 772-7302

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 2

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

• Alexis Pickens Collins, D.M.D.

  • Pediatric Dentistry
  • Irmo, SC
  • NPI 1003062753
  NPD Authorized official
• James Jacob Nyland, DDS

  • Dentist
  • Columbia, SC
  • NPI 1225102056
  NPD (past)

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

{
    "created_epoch": "1326758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672358400000",
    "number": "1851662274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1774 DUTCH FORK RD",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290638829",
            "telephone_number": "803-772-7302",
            "fax_number": "803-772-7353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "392 SAINT ANDREWS RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292104427",
            "telephone_number": "803-772-7302",
            "fax_number": "803-772-7353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALEXIS COLLINS CHILDRENS DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-17",
        "last_updated": "2022-12-30",
        "certification_date": "2022-12-30",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "ALEXIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-772-7302"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "SC",
            "license": "4507",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZX4507",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Z17072",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Milton Donald Alexander Jr., MD
• Nicole Alexander, PH.D.
• Shelby Jane Alexander, NP
• Tanika Alexander
• Valsa Alexander, RN
• Joleen Purpura Alfalahi, RD. LD
• Germine Wahid Alfonse, DO
• Omar Alfonso Gonzalez, APRN
• Bebbyn Schafer Alford, PHARM.D.
• Subrata Yorell Alford, APRN

• All providers in Columbia, SC
• Pediatric Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2022; 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.