Dr Byron K. Bridges DDS PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1171 Issued in SC

Legal business name

DR BYRON K. BRIDGES DDS PA

Practice address

3037 Geer Hwy
Marietta, SC 29661

Phone

(864) 836-8416

Fax

(864) 836-0780

NPI assigned

Nov 20, 2006

Last updated

Aug 20, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Bryon K. Bridges, DDS PA

Title

Dr

Phone

(864) 836-8416

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

Practitioners 1

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.

• Justin Degarmo, D.M.D.

  • Dentist
  • Marietta, SC
  • NPI 1285989111
  NPD (past)

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219190400000",
    "number": "1952475949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 491",
            "address_2": "3037 GERR HWY",
            "city": "MARIETTA",
            "state": "SC",
            "postal_code": "296610491",
            "telephone_number": "864-836-8416",
            "fax_number": "864-836-0780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3037 GEER HWY",
            "city": "MARIETTA",
            "state": "SC",
            "postal_code": "29661",
            "telephone_number": "864-836-8416",
            "fax_number": "864-836-0780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR BYRON K. BRIDGES DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2008-08-20",
        "status": "A",
        "authorized_official_last_name": "BRIDGES",
        "authorized_official_first_name": "BRYON",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "DR",
        "authorized_official_telephone_number": "864-836-8416",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS PA"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "1171",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Z11719",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZA11719",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1952475949",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Avalonia Group Homes, Inc.
• Justin Degarmo, D.M.D.
• Tiffany Nicole Edwards, COTA/L
• Falls Creek Living Center, LLC
• Happy Hooves, Inc.
• Healthstat on-Site Clinic/Milliken Enterprise
• Hope Health & Rehab of Marietta, LLC

• General Practice Dentistry in Marietta, SC
• Providers in Marietta, SC by specialty
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2008; 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.