Nicholas Parker Allen, DMD
Individual provider Active NPI Dentist · Anderson, SC
NPI 1962065268 · NPPES record last updated Oct 27, 2021
Key facts
- NPI
- 1962065268
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 9501 (SC)
- Practice address
- 2713 N Main St
Anderson, SC 29621-3282 - Phone
- (864) 226-8272
- NPI assigned
- Apr 22, 2019
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190910001317 | NC | Order and Referring Only - Dentist |
4284963620 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9501 | SC | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carolina Oaks Oconee, LLC | Dentist | Past |
Accepting new patients |
| Oconee Dental Associates,LLC | General Practice | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 9501 | SC | Yes |
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
Other providers in Anderson, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 27, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.