NPIMap

Organization Active NPI

Kool Smiles SC-2, PC

  • General Practice Dentistry
  • Anderson, SC
National Provider Identifier
1972898666
Registry record updated Dec 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
KOOL SMILES SC-2, PC
Practice address
629 Highway 28 Byp
Anderson, SC 29624-3009
Phone
(770) 916-9000
NPI assigned
Jun 10, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2014

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

Authorized official

Name
David Vieth, DDS
Title
President
Phone
(770) 916-5028

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223E0200X
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X

Addresses

Primary practice location

629 Highway 28 Byp
Anderson, SC 29624-3009

Mailing address

1090 Northchase Pkwy SE Ste 150
Marietta, GA 30067-6407
Phone (770) 916-9000

Other names 1

  • Kool Smiles Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Kool Smiles6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

625 Highway 28 Byp
Anderson, SC 29624
Phone (864) 642-0129

NPI Registry JSON

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

{
    "created_epoch": "1307664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418860800000",
    "number": "1972898666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 NORTHCHASE PKWY SE STE 150",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300676407",
            "telephone_number": "770-916-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 HIGHWAY 28 BYP",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296243009",
            "telephone_number": "770-916-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOOL SMILES SC-2, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-10",
        "last_updated": "2014-12-18",
        "status": "A",
        "authorized_official_last_name": "VIETH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-916-5028",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kool Smiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Anderson, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2014; 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.