Healthcare Provider Details

I. General information

NPI: 1972725299
Provider Name (Legal Business Name): JAMES NYLAND DDS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

392 ST ANDREWS ROAD
COLUMBIA SC
29210-4427
US

IV. Provider business mailing address

392 ST ANDREWS ROAD
COLUMBIA SC
29210-4427
US

V. Phone/Fax

Practice location:
  • Phone: 803-772-7302
  • Fax: 803-772-7353
Mailing address:
  • Phone: 803-772-7302
  • Fax: 803-772-7353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberSPECIALTY 0160
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number1707
License Number StateSC

VIII. Authorized Official

Name: DR. JAMES J NYLAND
Title or Position: OWNER PRESIDENT
Credential: DDS
Phone: 803-772-7302