Sea Glass Periodontics of Greenville
NPI 1568084408ActiveOrganization· Dentist, Periodontics· Greenville, SC
Dentist, Periodontics in Greenville, South Carolina, registered in NPPES in May 2020, part of Sea Glass Periodontics, LLC. The authorized official on file is Beth Illsley, Director Of Insurance.
Overview
| NPI | 1568084408 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Sea Glass Periodontics, LLC |
| NPI issued | May 14, 2020 |
| Last updated in NPPES | Oct 9, 2024 |
| Certified by provider | Oct 9, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, Periodontics Primary | 1223P0300X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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