Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Sea Glass Periodontics of Greenville

Organization Periodontics · NPI 1568084408

Sea Glass Periodontics of Greenville is a Periodontics in Greenville, South Carolina. Registered with an NPI since 2020.

In the registry since
2020

Practice location Address checks out

600 Congaree Rd
Greenville, SC 29607-3518
Phone: (864) 757-8820
Fax: (864) 751-6387
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Periodontics (primary) Taxonomy 1223P0300X

Record details

NPI number1568084408
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationSea Glass Periodontics, LLC
Authorized official Beth Illsley — Director Of Insurance · (864) 282-1935
Other names Sea Glass Periodontics Of Greenville; Diane Jenkins Periodontics Of Congaree Llc; Diane Jenkins Periodontics Of Congaree Llc
NPI enumeratedMay 14, 2020
Last updated in NPPESOctober 9, 2024
Certification dateOctober 9, 2024
Mailing address400 Memorial Drive Ext Ste 400, Greer, SC 29651-1850

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