Michelle Tartaglia, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

8517 Issued in SC

Practice address

2039 Medical Park Dr
Newberry, SC 29108-2249

Phone

(803) 276-3371

Fax

(803) 321-9042

NPI assigned

Oct 5, 2011

Last updated

May 24, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Miss Michelle Kelly Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Medical Park Dentistry

  • Dental Clinic/Center
  • Newberry, SC
  • NPI 1225761232
  NPD

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

{
    "created_epoch": "1317772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716508800000",
    "number": "1851675193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2039 MEDICAL PARK DR",
            "city": "NEWBERRY",
            "state": "SC",
            "postal_code": "291082249",
            "telephone_number": "803-276-3371",
            "fax_number": "803-321-9042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2039 MEDICAL PARK DR",
            "city": "NEWBERRY",
            "state": "SC",
            "postal_code": "291082249",
            "telephone_number": "803-276-3371",
            "fax_number": "803-321-9042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARTAGLIA",
        "first_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-05",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS038725",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "8517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "KELLY",
            "prefix": "MISS",
            "credential": "DMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ashley Worrall Stewart, PHARM.D.
• Pam S Stuck, RN
• Betty M Summer, CFNP
• Jennifer Summer
• Susan E Summerall, L.AC, DIPL. OM
• John Clay Taylor I, RPH
• The Free Medical Clinic of Newberry County, Inc.
• Jenelle Lorraine Thompson, CPSS, SAS, I-FPRS
• Toxicology X Diagnostics Screenings
• Petra Steen Ulch, RN

• Dentist in Newberry, SC
• Providers in Newberry, SC by specialty
• Dentist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2024; 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.