OrganizationActive
Sea Glass Periodontics of Greenville
NPI 1568084408 · Periodontics · Greenville, SC
Sea Glass Periodontics of Greenville is a Periodontics organization in Greenville, SC (NPI 1568084408).
Provider details
- NPI number
- 1568084408
- Entity type
- Organization
- Primary specialty
- PeriodonticsDental Providers
- Parent organization
- Sea Glass Periodontics, LLC
- Organization subpart
- Yes
- Authorized official
- Beth Illsley, Director of Insurance(864) 282-1935
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(64/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
600 Congaree Rd
Greenville, SC 29607-3518
Phone: (864) 757-8820
Fax: (864) 751-6387
Street-level locationGet directions
Mailing address
400 Memorial Drive Ext Ste 400
Greer, SC 29651-1850
Other names (DBA / former)
- Former legal business name
- Diane Jenkins Periodontics of Congaree LLC
- Former legal business name
- Diane Jenkins Periodontics of Congaree LLC
- Doing business as
- Sea Glass Periodontics of Greenville
Registry dates
- Enumerated
- 2020-05-14
- Last updated
- 2024-10-09
- Certified
- 2024-10-09
Frequently asked questions
- What is Sea Glass Periodontics of Greenville's NPI number?
- Sea Glass Periodontics of Greenville's National Provider Identifier (NPI) is 1568084408, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Sea Glass Periodontics of Greenville?
- Sea Glass Periodontics of Greenville is classified in the NPPES registry as Periodontics (Dental Providers).
- Where is Sea Glass Periodontics of Greenville located?
- Sea Glass Periodontics of Greenville's practice location on file with NPPES is 600 Congaree Rd, Greenville, SC 29607-3518.
- What is Sea Glass Periodontics of Greenville's phone number?
- The practice phone number listed in the NPPES registry for Sea Glass Periodontics of Greenville is (864) 757-8820.
- Who is the authorized official for Sea Glass Periodontics of Greenville?
- The authorized official listed on Sea Glass Periodontics of Greenville's NPPES record is Beth Illsley, Director of Insurance. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Sea Glass Periodontics of Greenville's NPI active?
- Yes — Sea Glass Periodontics of Greenville's NPI (1568084408) is active in the NPPES registry as of the last update on 2024-10-09.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.