Individual provider Active NPI

Nicholas Parker Allen, DMD

  • Dentist
  • Anderson, SC
National Provider Identifier
1962065268
Registry record updated Oct 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
9501 Issued in SC
Practice address
2713 N Main St
Anderson, SC 29621-3282
Phone
(864) 226-8272
NPI assigned
Apr 22, 2019
Last updated
Oct 27, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 9501 SC Primary

Addresses

Primary practice location

2713 N Main St
Anderson, SC 29621-3282

Mailing address

2713 N Main St
Anderson, SC 29621-3282
Phone (864) 226-8272

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190910001317 NC Order and Referring Only - DentistPractitioner - Dentist 4284963620

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9501SCMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Oconee Dental Associates,LLC General Practice PastSince Jun 1, 2020 Accepting new patients
Carolina Oaks Oconee, LLC Dentist PastSince Jun 1, 2020 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1555891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1962065268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2713 N MAIN ST",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296213282",
            "telephone_number": "864-226-8272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2713 N MAIN ST",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296213282",
            "telephone_number": "864-226-8272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "NICHOLAS",
        "middle_name": "PARKER",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-22",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "9501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, SC

Sources for this page

Verify at the official NPI Registry.