NPIMap

Organization Active NPI

Palmetto Advanced Dentistry

  • Dental Clinic/Center
  • Indian Land, SC
National Provider Identifier
1851916332
Registry record updated Jun 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
PALMETTO ADVANCED DENTISTRY
Practice address
2021 Bridgemill Dr Ste 100
Indian Land, SC 29707-9211
Phone
(803) 848-7100
NPI assigned
Jun 10, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2020

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

Authorized official

Name
Dr. Albert Primavera, DMDNPI 1609353606
Title
Owner
Phone
(239) 273-3981

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
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

2021 Bridgemill Dr Ste 100
Indian Land, SC 29707-9211

Mailing address

1061 Ansley Park Dr
Indian Land, SC 29707-7885

National Provider Directory

National Provider Directory

Locations

2021 Bridgemill Dr
Ste 100
Indian Land, SC 29707
Phone (803) 848-7100

Practitioners & affiliated clinicians

Practitioners 1

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": "1591747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591747200000",
    "number": "1851916332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1061 ANSLEY PARK DR",
            "city": "INDIAN LAND",
            "state": "SC",
            "postal_code": "297077885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 BRIDGEMILL DR STE 100",
            "city": "INDIAN LAND",
            "state": "SC",
            "postal_code": "297079211",
            "telephone_number": "803-848-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO ADVANCED DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-10",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A",
        "authorized_official_last_name": "PRIMAVERA",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-273-3981",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indian Land, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2020; 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.