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PALMETTO DENTAL
NPI 1275908923
Dentist - General Practice in Rock Hill, SC

Active since December 07, 2015
1578 CONSTITUTION BLVD, STE 01, ROCK HILL, SC 29732(803) 366-1456(803) 324-0117 Get Directions Write a Review

NPPES record last updated: December 7, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Palmetto Dental NPPES

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

PALMETTO DENTAL (NPI 1275908923) is a healthcare organization registered as a general practice in Rock Hill, South Carolina and active in the NPI registry since December 2015. The organization lists Jae Sung Park, President, as its authorized official.

NPPES Registry Identity

NPI1275908923
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NamePARK DENTAL GROUP, LLC
Location Address1578 CONSTITUTION BLVD, STE 01Rock Hill, SC 29732-3543
Mailing Address1578 Constitution Blvd, Ste 01Rock Hill, SC 29732-3543 · (803) 366-1456 · Fax (803) 324-0117
Phone(803) 366-1456
Fax(803) 324-0117
Organization SubpartNo
Authorized OfficialJae Sung ParkPresident · (803) 366-1456
Enumeration DateDecember 7, 2015
✔ NPI 1275908923 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in SC · 8288
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.
1578 CONSTITUTION BLVD, Rock Hill, SC 29732
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Other Names 1

Doing Business AsPalmetto Dental

Other Identifiers 1

MedicaidZX8288SC

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

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JAE SUNG PARK D.M.D.
Dentist (General Practice)
1578 CONSTITUTION BLVD, SUITE 01
ROCK HILL, SC 29732
York County (803) 366-1456
PALMETTO SURGERY LLC
Surgery
1578 CONSTITUTION BLVD, 01
ROCK HILL, SC 29732
York County (803) 324-5858

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 Park Dental Group, LLC's NPI number?

The NPI number for Park Dental Group, LLC is 1275908923. It was assigned to this organization in the NPPES registry on December 7, 2015. The provider is doing business as Palmetto Dental.

Where is Park Dental Group, LLC located?

Park Dental Group, LLC is located at 1578 Constitution Blvd Ste 01, Rock Hill, SC 29732. The listed phone number is (803) 366-1456.

What is Park Dental Group, LLC's specialty?

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

When was this NPI record last updated?

The NPPES record for Park Dental Group, LLC was last updated on December 7, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.