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

Sea Glass Periodontics of Simpsonville LLC

Organization Periodontics · NPI 1295344646

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

In the registry since
2020
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

110A Hospital Dr
Simpsonville, SC 29681-3226
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 number1295344646
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationSea Glass Periodontics
Authorized official Beth Illsley — Director Of Insurance · (864) 282-1935
NPI enumeratedJuly 30, 2020
Last updated in NPPESJuly 30, 2020
Certification dateJuly 30, 2020
Mailing address400 Memorial Drive Ext Ste 400, Greer, SC 29651-1850