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SEA GLASS PERIODONTICS OF SIMPSONVILLE LLC
NPI 1295344646
Dentist - Periodontics in Simpsonville, SC

Active since July 30, 2020
110A HOSPITAL DR, SIMPSONVILLE, SC 29681(864) 757-8820(864) 751-6387 Get Directions Write a Review

NPPES record last updated: July 30, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Sea Glass Periodontics Of Simpsonville Llc NPPES

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

SEA GLASS PERIODONTICS OF SIMPSONVILLE LLC (NPI 1295344646) is a healthcare organization registered as a periodontics in Simpsonville, South Carolina and active in the NPI registry since July 2020. The organization lists Beth Illsley, Director Of Insurance, as its authorized official.

NPPES Registry Identity

NPI1295344646
Entity TypeOrganization
Primary Taxonomy1223P0300X
Legal Business NameSEA GLASS PERIODONTICS OF SIMPSONVILLE LLC
Location Address110A HOSPITAL DRSimpsonville, SC 29681-3226
Mailing Address400 Memorial Drive Ext Ste 400Greer, SC 29651-1850 · (864) 282-1935 · Fax (864) 751-6387
Phone(864) 757-8820
Fax(864) 751-6387
Organization SubpartYesParent: Sea Glass Periodontics
Authorized OfficialBeth IllsleyDirector Of Insurance · (864) 282-1935
Enumeration DateJuly 30, 2020
NPPES CertifiedJuly 30, 2020
✔ NPI 1295344646 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · PeriodonticsDental Providers
Taxonomy Code1223P0300X
Definition
That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
110A HOSPITAL DR, Simpsonville, SC 29681
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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 6

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

MR. GABRIEL MARTIN HOLLEY DDS, MS
Dentist (General Practice)
110A HOSPITAL DR
SIMPSONVILLE, SC 29681
Greenville County (304) 377-0014
DR. CHRISTOPHER ALAN HAGGARD DMD
Dentist
110A HOSPITAL DR
SIMPSONVILLE, SC 29681
Greenville County (864) 757-8820
KRISHNA KUMAR PUDI MD PA
Internal Medicine
110A HOSPITAL DR
SIMPSONVILLE, SC 29681
Greenville County (864) 963-9090
CAROLINA UPPER-CERVICAL LLC
Chiropractor
110A HOSPITAL DR
SIMPSONVILLE, SC 29681
Greenville County (864) 551-2096
HOLLEY ENDODONTICS, PA
Clinic/Center (Dental)
110A HOSPITAL DR
SIMPSONVILLE, SC 29681
Greenville County (864) 987-7030
DR. DIANE WATT JENKINS DMD
Dentist
110A HOSPITAL DR
SIMPSONVILLE, SC 29681
Greenville County (864) 757-8820

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 Sea Glass Periodontics Of Simpsonville LLC's NPI number?

The NPI number for Sea Glass Periodontics Of Simpsonville LLC is 1295344646. It was assigned to this organization in the NPPES registry on July 30, 2020.

Where is Sea Glass Periodontics Of Simpsonville LLC located?

Sea Glass Periodontics Of Simpsonville LLC is located at 110A Hospital Dr, Simpsonville, SC 29681. The listed phone number is (864) 757-8820.

What is Sea Glass Periodontics Of Simpsonville LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

When was this NPI record last updated?

The NPPES record for Sea Glass Periodontics Of Simpsonville LLC was last updated on July 30, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.