NPI 1093632481 · live from the CMS NPI Registry
Greenville Ortho LLC
Dentist, Orthodontics and Dentofacial Orthopedics in Greenville, SC. National Provider Identifier 1093632481, active.
NPI record
| NPI | 1093632481 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dentist, Orthodontics and Dentofacial Orthopedics 1223X0400X |
| Practice location | 105 State Park Rd, Greenville, SC 29609 |
| Practice phone | 864-586-1202 |
| Enumerated | July 6, 2026 |
| Last updated | July 6, 2026 |
| Authorized official | Jenni Tomlinson, Credentialing And Enrollment |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, Orthodontics and Dentofacial Orthopedics primary | 1223X0400X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.