NPIMap

Organization Active NPI

Classic Dental Group

  • Dentist
  • Greenville, SC
National Provider Identifier
1902458474
Registry record updated Jul 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
CLASSIC DENTAL GROUP
Practice address
6A Cleveland CT
Greenville, SC 29607-2414
Phone
(864) 283-0141
NPI assigned
Jul 15, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2019

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

Authorized official

Name
Tyresia J White, DMDNPI 1346682754
Title
Periodontist
Phone
(864) 283-0141

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
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

6A Cleveland CT
Greenville, SC 29607-2414

Mailing address

6A Cleveland CT
Greenville, SC 29607-2414
Phone (864) 283-0141

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1563148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563148800000",
    "number": "1902458474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6A CLEVELAND CT",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296072414",
            "telephone_number": "864-283-0141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6A CLEVELAND CT",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296072414",
            "telephone_number": "864-283-0141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLASSIC DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-15",
        "last_updated": "2019-07-15",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "TYRESIA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PERIODONTIST",
        "authorized_official_telephone_number": "864-283-0141",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

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