Active NPI
Shawn Lee Thompson, D.D.S.
- Dentist
- Columbia, SC
National Provider Identifier
1881808657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 10598
- Practice address
- 3790 Fernandina Rd Ste 201
Columbia, SC 29210-3864 - Phone
- (803) 678-9999
- NPI assigned
- May 10, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 20609 | OH | |
| Dentist | 122300000X | 10598 | SC | Primary |
Addresses
Primary practice location
3790 Fernandina Rd Ste 201
Columbia, SC 29210-3864
Mailing address
3790 Fernandina Rd Ste 201
Columbia, SC 29210-3864
Phone (803) 678-9999
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10598 | SC | MD | Dentist |
| 20609 | OH | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jackson Smile Studio - Sda LLC | General Practice | Current | Accepting new patients |
| Shawn Lee Thompson DDS Inc | Past | Accepting new patients |
Locations
3790 Fernandina Rd
Ste 201
Columbia, SC 29210
Phone (803) 678-9999
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Durable Medical Equipment & Medical Supplies
- Pemberville, OH
- NPI 1386912426
-
- General Practice Dentistry
- Columbia, SC
- NPI 1548738636
General Practice
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696809600000",
"number": "1881808657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3790 FERNANDINA RD STE 201",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292103864",
"telephone_number": "803-678-9999"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3790 FERNANDINA RD STE 201",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292103864",
"telephone_number": "803-678-9999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMPSON",
"first_name": "SHAWN",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-10",
"last_updated": "2023-10-09",
"certification_date": "2023-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OH",
"license": "20609",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "SC",
"license": "10598",
"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 Oct 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.