NPI 1124635495 · live from the CMS NPI Registry
Destination Dental Of Duncan LLC
Dentist, General Practice in Duncan, SC. National Provider Identifier 1124635495, active.
NPI record
| NPI | 1124635495 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dentist, General Practice 1223G0001X |
| Practice location | 155 Deacon Tiller Ct, Duncan, SC 29334 |
| Practice phone | 864-485-2214 |
| Mailing address | 401 Commerce Dr Ste 108, Fort Washington, PA 19034 |
| Enumerated | September 30, 2020 |
| Last updated | September 30, 2020 |
| Authorized official | Niranjan Savani, Owner |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, Pediatric Dentistry | 1223P0221X | — |
| Dentist, Periodontics | 1223P0300X | — |
| Dentist, Prosthodontics | 1223P0700X | — |
| Dentist, Oral and Maxillofacial Surgery | 1223S0112X | — |
| Dentist, Orthodontics and Dentofacial Orthopedics | 1223X0400X | — |
| Dentist, General Practice primary | 1223G0001X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.