Walsh Dental Associates

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3739 Issued in SC

Legal business name

WALSH DENTAL ASSOCIATES

Practice address

219B N Mine St
MC Cormick, SC 29835-8363

Phone

(864) 852-2571

Fax

(864) 852-2674

NPI assigned

Apr 16, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Gary Warren Walsh Jr., D.M.D.

Title

Owner/President

Phone

(864) 852-2571

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1271376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271376000000",
    "number": "1922324847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219B N MINE ST",
            "city": "MC CORMICK",
            "state": "SC",
            "postal_code": "298358363",
            "telephone_number": "864-852-2571",
            "fax_number": "864-852-2674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219B N MINE ST",
            "city": "MC CORMICK",
            "state": "SC",
            "postal_code": "298358363",
            "telephone_number": "864-852-2571",
            "fax_number": "864-852-2674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALSH DENTAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-16",
        "last_updated": "2010-04-16",
        "status": "A",
        "authorized_official_last_name": "WALSH",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "WARREN",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "864-852-2571",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "3739",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZX3739",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Betty J Speach, LMSW
• Erin Ledford Talbert, MSN, RN, APRN, FNP-C
• Catherine Alicia Tapp
• Monica Trausch
• Samir Vaid, D.P.T
• Ashley C Wiggins, M.D.

• All providers in MC Cormick, SC
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2010; 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.