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HOLLY TREE FAMILY DENTAL, PA
NPI 1245994342
Dentist - General Practice in Simpsonville, SC

Active since October 25, 2021CLIA 42D2231702 · Waiver
1334 S. HIGHWAY 14, SIMPSONVILLE, SC 29681(864) 297-5585(864) 297-4166 Get Directions Write a Review

NPPES record last updated: October 25, 2021. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Holly Tree Family Dental, Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HOLLY TREE FAMILY DENTAL, PA (NPI 1245994342), doing business as Bynum Aesthetic Dentistry, is a healthcare organization registered as a general practice in Simpsonville, South Carolina and active in the NPI registry since October 2021. The organization holds a CLIA Waiver certificate valid through August 4, 2027 and lists Matthew James Bynum, Owner, as its authorized official.

NPPES Registry Identity

NPI1245994342
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameHOLLY TREE FAMILY DENTAL, PA
Location Address1334 S. HIGHWAY 14Simpsonville, SC 29681
Mailing Address1334 S. Highway 14Simpsonville, SC 29681 · (864) 297-5585 · Fax (864) 297-4166
Phone(864) 297-5585
Fax(864) 297-4166
Organization SubpartYes
Authorized OfficialMatthew James BynumOwner · (864) 297-5585
Enumeration DateOctober 25, 2021
NPPES CertifiedOctober 25, 2021
✔ NPI 1245994342 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
1334 S. HIGHWAY 14, Simpsonville, SC 29681
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Other Names 1

Doing Business AsBynum Aesthetic Dentistry

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 42D2231702

Holly Tree Family Dental, PA · Simpsonville, SC
Active · expires Aug 4, 2027
CLIA Number42D2231702
Laboratory TypeDental Office
Certificate Effective DateAugust 5, 2025
Certificate Expiration DateAugust 4, 2027
Laboratory DirectorDr. Matthew I. Bynum
Laboratory Phone(864) 297-5585
Laboratory LocationHolly Tree Family Dental, PA1334 S Hwy 14, Simpsonville, SC 29681
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Holly Tree Family Dental, PA's NPI number?

The NPI number for Holly Tree Family Dental, PA is 1245994342. It was assigned to this organization in the NPPES registry on October 25, 2021. The provider is doing business as Bynum Aesthetic Dentistry.

Where is Holly Tree Family Dental, PA located?

Holly Tree Family Dental, PA is located at 1334 S. Highway 14, Simpsonville, SC 29681. The listed phone number is (864) 297-5585.

What is Holly Tree Family Dental, PA's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Does Holly Tree Family Dental, PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 42D2231702) is associated with this NPI, valid through August 4, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Holly Tree Family Dental, PA was last updated on October 25, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.