Carolina Aesthetic Dentistry PA

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

SC3390 Issued in SC

Legal business name

CAROLINA AESTHETIC DENTISTRY PA

Practice address

383 South Pine Street
Suite 3
Spartanburg, SC 29302

Phone

(864) 577-9400

Fax

(864) 577-9773

NPI assigned

Aug 25, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Katherine Melissa Nicholson, DMD

Title

Dentist

Phone

(864) 577-9400

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1922115658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "383 SOUTH PINE STREET",
            "address_2": "SUITE 3",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "29302",
            "telephone_number": "864-577-9400",
            "fax_number": "864-577-9773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "383 SOUTH PINE STREET",
            "address_2": "SUITE 3",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "29302",
            "telephone_number": "864-577-9400",
            "fax_number": "864-577-9773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA AESTHETIC DENTISTRY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NICHOLSON",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_middle_name": "MELISSA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "864-577-9400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": "SC",
            "license": "SC3390",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZA9539",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "233900",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Harrison Carnes, PA-C
• Kathryn Camille Carnes, DMD
• Melody J. Carnes, LCSW
• Michelle Cathleen Carney, MD
• Carol Nichols & Carol Kooistra
• Carolina Attachment and Trauma Services
• Carolina Behavioral Care, LLC
• Carolina Center for Diabetes Education
• Carolina Ctr for Oral & Maxillofacial Surgery
• Carolina Dental Docs - on - the - Go, LLC

• All providers in Spartanburg, SC
• Endodontics in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.