NPIMap

Organization Active NPI

Foothills Pediatric Dentistry, PA

  • Pediatric Dentistry
  • Spartanburg, SC
National Provider Identifier
1891938973
Registry record updated Nov 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
4566 Issued in SC
Legal business name
FOOTHILLS PEDIATRIC DENTISTRY, PA
Practice address
240 N Grove Medical Park Dr
Spartanburg, SC 29303-4222
Phone
(864) 699-6382
Fax
(864) 699-6382
NPI assigned
Apr 20, 2009
Last updated
Nov 15, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2019

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

Authorized official

Name
Dr. Steven Michael Bozard, DMDNPI 1184866477
Title
President
Phone
(864) 699-6382

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
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 4566 SC Primary

Addresses

Primary practice location

240 N Grove Medical Park Dr
Spartanburg, SC 29303-4222

Mailing address

240 N Grove Medical Park Dr
Spartanburg, SC 29303-4222
Phone (864) 699-6382

National Provider Directory

National Provider Directory

Locations

240 North Grove Medical Park Dr
Spartanburg, SC 29303
Phone (864) 699-6382

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1240185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573776000000",
    "number": "1891938973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 N GROVE MEDICAL PARK DR",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293034222",
            "telephone_number": "864-699-6382",
            "fax_number": "864-699-6382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 N GROVE MEDICAL PARK DR",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293034222",
            "telephone_number": "864-699-6382",
            "fax_number": "864-699-6382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOTHILLS PEDIATRIC DENTISTRY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-20",
        "last_updated": "2019-11-15",
        "status": "A",
        "authorized_official_last_name": "BOZARD",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "864-699-6382",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "SC",
            "license": "4566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2019; 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.