Dutch Fork Family Dentistry, PA

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

4654 Issued in SC

Legal business name

DUTCH FORK FAMILY DENTISTRY, PA

Practice address

7436 Broad River Rd Ste 111
Irmo, SC 29063-7601

Phone

(803) 749-3333

Fax

(803) 749-3335

NPI assigned

Feb 19, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Sherry Benenhaley Rauch, DDSNPI 1619139482

Title

President

Phone

(803) 749-3333

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Sherry Benenhaley Rauch, DDS

  • General Practice Dentistry
  • Irmo, SC
  • NPI 1619139482
  NPD (past) Authorized official

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

{
    "created_epoch": "1361232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361232000000",
    "number": "1104166792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7436 BROAD RIVER RD STE 111",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290637601",
            "telephone_number": "803-749-3333",
            "fax_number": "803-749-3335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7436 BROAD RIVER RD STE 111",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290637601",
            "telephone_number": "803-749-3333",
            "fax_number": "803-749-3335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUTCH FORK FAMILY DENTISTRY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-19",
        "last_updated": "2013-02-19",
        "status": "A",
        "authorized_official_last_name": "RAUCH",
        "authorized_official_first_name": "SHERRY",
        "authorized_official_middle_name": "BENENHALEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "803-749-3333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "SC",
            "license": "4654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joel Wesley Duncan, MD
• Tamarille Duncan, PTA
• Lora L. Dunn, LMBT, NCTMB
• Lense Tessema Duresso, MD
• Dutch Fork Chiropractic Center PA
• Dutch Fork Family Practice
• Dutch Fork Psychological Services
• Kaitlyn Edgington, PA-C
• Cynthia Dianne Edsel
• Nicole Sovde Edwards, MSP. CCC-SLP

• Dental Clinic/Center in Irmo, SC
• Providers in Irmo, SC by specialty
• Dental Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.