NPIMap

Organization Active NPI

Palmetto Family Orthodontics LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Greenville, SC
National Provider Identifier
1912196684
Registry record updated Nov 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
681 Issued in SC
Legal business name
PALMETTO FAMILY ORTHODONTICS LLC
Practice address
105 Halton Village Cir
Suite B
Greenville, SC 29607-6833
Phone
(864) 335-0505
Fax
(864) 335-0508
NPI assigned
Oct 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2012

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

Authorized official

Name
Dr. David F Watson III, DMD MPH
Title
Co-Owner
Phone
(864) 335-0505

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223X0400X 681 SC Primary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223X0400X 4287 SC

Addresses

Primary practice location

105 Halton Village Cir
Suite B
Greenville, SC 29607-6833

Mailing address

105 Halton Village Cir
Suite B
Greenville, SC 29607-6833
Phone (864) 335-0505

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1192665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352764800000",
    "number": "1912196684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 HALTON VILLAGE CIR",
            "address_2": "SUITE B",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296076833",
            "telephone_number": "864-335-0505",
            "fax_number": "864-335-0508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 HALTON VILLAGE CIR",
            "address_2": "SUITE B",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296076833",
            "telephone_number": "864-335-0505",
            "fax_number": "864-335-0508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO FAMILY ORTHODONTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-18",
        "last_updated": "2012-11-13",
        "status": "A",
        "authorized_official_last_name": "WATSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "864-335-0505",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DMD MPH"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "SC",
            "license": "681",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "SC",
            "license": "4287",
            "primary": false
        }
    ],
    "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 Nov 13, 2012; 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.