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SEA GLASS PERIODONTICS OF GREENVILLE
NPI 1568084408
Dentist - Periodontics in Greenville, SC

Active since May 14, 2020
600 CONGAREE RD, GREENVILLE, SC 29607(864) 757-8820(864) 751-6387 Get Directions Write a Review

NPPES record last updated: October 9, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 9, 2024, Oct 5, 2020, Jul 30, 2020 and 1 more (4 updates tracked since 2020).

About Sea Glass Periodontics Of Greenville NPPES

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

SEA GLASS PERIODONTICS OF GREENVILLE (NPI 1568084408), doing business as Diane Jenkins Periodontics Of Congaree Llc, is a healthcare organization registered as a periodontics in Greenville, South Carolina and active in the NPI registry since May 2020. The organization lists Beth Illsley, Director Of Insurance, as its authorized official.

NPPES Registry Identity

NPI1568084408
Entity TypeOrganization
Primary Taxonomy1223P0300X
Legal Business NameSEA GLASS PERIODONTICS OF GREENVILLE
Location Address600 CONGAREE RDGreenville, SC 29607-3518
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, Llc
Authorized OfficialBeth IllsleyDirector Of Insurance · (864) 282-1935
Enumeration DateMay 14, 2020
Last NPPES UpdateOctober 9, 20244 updates tracked since enumeration
NPPES CertifiedOctober 9, 2024
✔ NPI 1568084408 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.
600 CONGAREE RD, Greenville, SC 29607
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Other Names 2

Former Legal Business NameDiane Jenkins Periodontics Of Congaree Llc
Doing Business AsSea Glass Periodontics Of Greenville

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of South Carolina.Insurance ›

Other Providers at the Same Location NPPES

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

STEPHANIE IRENE DRAKE DDS
Dentist (Periodontics)
600 CONGAREE RD
GREENVILLE, SC 29607
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 Greenville's NPI number?

The NPI number for Sea Glass Periodontics Of Greenville is 1568084408. It was assigned to this organization in the NPPES registry on May 14, 2020. The provider was formerly known as Diane Jenkins Periodontics Of Congaree LLC.

Where is Sea Glass Periodontics Of Greenville located?

Sea Glass Periodontics Of Greenville is located at 600 Congaree Rd, Greenville, SC 29607. The listed phone number is (864) 757-8820.

What is Sea Glass Periodontics Of Greenville's specialty?

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

What insurance does Sea Glass Periodontics Of Greenville accept?

Health plans from BlueCross BlueShield of South Carolina list Sea Glass Periodontics Of Greenville as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Sea Glass Periodontics Of Greenville was last updated on October 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months 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.