Provider Demographics
NPI:1942226931
Name:PADGETT, JAMES GRAHAM JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:GRAHAM
Last Name:PADGETT
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 GRACE STREET
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29649
Mailing Address - Country:US
Mailing Address - Phone:864-229-6084
Mailing Address - Fax:864-229-2740
Practice Address - Street 1:230 GRACE STREET
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29649
Practice Address - Country:US
Practice Address - Phone:864-229-6084
Practice Address - Fax:864-229-2740
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSC18971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCZ18972Medicaid