NPIMap

Organization Active NPI

Dr. George H. Fann, D.M.D., P.a.

  • Dentist
  • West Columbia, SC
National Provider Identifier
1013256627
Registry record updated Feb 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
DR. GEORGE H. FANN, D.M.D., P.A.
Practice address
111 Professional Ave
West Columbia, SC 29169-4711
Phone
(803) 796-0666
Fax
(803) 796-8753
NPI assigned
Feb 4, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Todd ElliottNPI 1326387929
Title
Owner
Phone
(803) 796-0666

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

111 Professional Ave
West Columbia, SC 29169-4711

Mailing address

111 Professional Ave
West Columbia, SC 29169-4711
Phone (803) 796-0666

National Provider Directory

National Provider Directory

Locations

111 Professional Ave
West Columbia, SC 29169
Phone (803) 796-0666

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1359936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359936000000",
    "number": "1013256627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 PROFESSIONAL AVE",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291694711",
            "telephone_number": "803-796-0666",
            "fax_number": "803-796-8753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 PROFESSIONAL AVE",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291694711",
            "telephone_number": "803-796-0666",
            "fax_number": "803-796-8753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. GEORGE H. FANN, D.M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-04",
        "last_updated": "2013-02-04",
        "status": "A",
        "authorized_official_last_name": "ELLIOTT",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-796-0666",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.