NPIMap

Organization Active NPI

Family Dental Health of Five Forks LLC

  • General Practice Dentistry
  • Simpsonville, SC
National Provider Identifier
1013266477
Registry record updated Oct 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
FAMILY DENTAL HEALTH OF FIVE FORKS LLC
Practice address
216 Scuffletown Rd Ste D
Simpsonville, SC 29681-7296
Phone
(864) 365-0900
Fax
(864) 282-1955
NPI assigned
Aug 31, 2012
Organization subpart
Yes
Parent organization
FDH HOLDINGS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 5, 2020

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

Authorized official

Name
Dr. Bobby Monroe Safrit II, DMD
Title
Owner
Phone
(864) 282-1935

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X SC Primary

Addresses

Primary practice location

216 Scuffletown Rd Ste D
Simpsonville, SC 29681-7296

Mailing address

400 Memorial Drive Ext Ste 400
Greer, SC 29651-1850
Phone (864) 282-1935

National Provider Directory

National Provider Directory

Locations

216 Scuffletown Rd
Ste D
Simpsonville, SC 29681
Phone (864) 203-8540

Practitioners & affiliated clinicians

Practitioners 6

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": "1346371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601856000000",
    "number": "1013266477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 MEMORIAL DRIVE EXT STE 400",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296511850",
            "telephone_number": "864-282-1935",
            "fax_number": "864-751-6387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 SCUFFLETOWN RD STE D",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296817296",
            "telephone_number": "864-365-0900",
            "fax_number": "864-282-1955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DENTAL HEALTH OF FIVE FORKS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FDH HOLDINGS, LLC",
        "enumeration_date": "2012-08-31",
        "last_updated": "2020-10-05",
        "certification_date": "2020-10-05",
        "status": "A",
        "authorized_official_last_name": "SAFRIT",
        "authorized_official_first_name": "BOBBY",
        "authorized_official_middle_name": "MONROE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "864-282-1935",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simpsonville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2020; 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.