Welvista

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

WELVISTA

Doing business as

Allendale Smiles for a Lifetime

Practice address

3269 Allendale Fairfax Hwy
Fairfax, SC 29827-9163

Phone

(803) 584-4803

Fax

(803) 584-4806

NPI assigned

Oct 18, 2006

Last updated

Sep 20, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Georgia Bennett Famuliner

Title

Operations Director

Phone

(803) 584-4803

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Allendale Smiles for a Lifetime Doing business as

Tax ID family

Welvista7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

• Welvista

  • Community/Retail Pharmacy
  • Columbia, SC
  • NPI 1023200441
  NPD tax ID
• Welvista

  • General Practice Dentistry
  • Varnville, SC
  • NPI 1023527348
  NPD tax ID
• Welvista

  dba Summerton Smiles for a Lifetime

  • General Practice Dentistry
  • Summerton, SC
  • NPI 1386727188
  NPD tax ID
• Welvista

  dba Clarendon Smiles for a Lifetime

  • General Practice Dentistry
  • Manning, SC
  • NPI 1619058591
  NPD tax ID
• Welvista

  • Pharmacy
  • Columbia, SC
  • NPI 1861796518
  NPD tax ID
• Welvista

  dba Dillon Two Smiles for a Lifetime

  • General Practice Dentistry
  • Dillon, SC
  • NPI 1922189885
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John Terry Poole III, D.M.D.

  • General Practice Dentistry
  • Summerville, SC
  • NPI 1104911346
  NPD (past)
• Jenni Marie O'Malley, D.M.D

  • Dentist
  • Kingsport, TN
  • NPI 1609144997

  General Practice

  NPD (past)

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505865600000",
    "number": "1033290937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 221",
            "city": "ALLENDALE",
            "state": "SC",
            "postal_code": "298100221",
            "telephone_number": "803-584-4803",
            "fax_number": "803-584-4806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3269 ALLENDALE FAIRFAX HWY",
            "city": "FAIRFAX",
            "state": "SC",
            "postal_code": "298279163",
            "telephone_number": "803-584-4803",
            "fax_number": "803-584-4806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELVISTA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2017-09-20",
        "status": "A",
        "authorized_official_last_name": "FAMULINER",
        "authorized_official_first_name": "GEORGIA",
        "authorized_official_middle_name": "BENNETT",
        "authorized_official_title_or_position": "OPERATIONS DIRECTOR",
        "authorized_official_telephone_number": "803-584-4803",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZA9677",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Allendale Smiles for a Lifetime",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael Robert Torkelson, M. D.
• Wanda W Tutt, LRD
• Kelly Futch Wall, MA, CF-SLP
• Sandra Lee Washington Bennett, MA, APC
• We Care Family Resource LLC
• Eunice E White, R.N. B.S.N. C.D.E
• Wholesome Healing Doula and Wellness
• Rebecca Lynn Wilkes, NURSE PRACTITIONER

• General Practice Dentistry in Fairfax, SC
• Providers in Fairfax, SC by specialty
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2017; 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.