Organization Active NPI

VSM Columbia Pediatric Dentistry

  • Pediatric Dentistry
  • Columbia, SC
National Provider Identifier
1881015451
Registry record updated Dec 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
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

Updated by the provider on Dec 26, 2013

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)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 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 Directory

NPI 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.

Verify at the official NPI Registry.