Active NPI
VSM Columbia Pediatric Dentistry
- Pediatric Dentistry
- Columbia, SC
National Provider Identifier
1881015451
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- Legal business name
- VSM COLUMBIA PEDIATRIC DENTISTRY
- Practice address
- 2302 Bush River Rd
Columbia, SC 29210-5649 - Phone
- (803) 798-8675
- NPI assigned
- Dec 26, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Crystal Walker
- Title
- Credentialing Coordinator
- Phone
- (404) 410-1343
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | Primary |
Addresses
Primary practice location
2302 Bush River Rd
Columbia, SC 29210-5649
Mailing address
2302 Bush River Rd
Columbia, SC 29210-5649
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1388016000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1388016000000",
"number": "1881015451",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2302 BUSH RIVER RD",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292105649"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2302 BUSH RIVER RD",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292105649",
"telephone_number": "803-798-8675"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VSM COLUMBIA PEDIATRIC DENTISTRY",
"organizational_subpart": "NO",
"enumeration_date": "2013-12-26",
"last_updated": "2013-12-26",
"status": "A",
"authorized_official_last_name": "WALKER",
"authorized_official_first_name": "CRYSTAL",
"authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
"authorized_official_telephone_number": "404-410-1343"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, Pediatric Dentistry",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.