Foothills Oral & Facial Surgery, PA

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

4084 Issued in SC

Legal business name

FOOTHILLS ORAL & FACIAL SURGERY, PA

Practice address

634 Fairview Rd
Building C
Simpsonville, SC 29680

Phone

(864) 967-4000

NPI assigned

Jan 8, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Victor Lebedovych, DDSNPI 1104849314

Title

President

Phone

(864) 967-4000

Specialties & licenses 1

Addresses

Tax ID family

Foothills Oral Facial Surgery2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Foothills Oral & Facial Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Anderson, SC
  • NPI 1134549629
  NPD tax ID

Locations

Practitioners 1

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

• Victor Paul Lebedovych, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Simspnville, SC
  • NPI 1104849314
  NPD (past) Authorized official

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104974609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "634 FAIRVIEW RD",
            "address_2": "BUILDING C",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "29680",
            "telephone_number": "864-967-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "634 FAIRVIEW RD",
            "address_2": "BUILDING C",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "29680",
            "telephone_number": "864-967-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOTHILLS ORAL & FACIAL SURGERY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LEBEDOVYCH",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "864-967-4000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "SC",
            "license": "4084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Carroll Fletcher, APRN
• Nigel George Fletcher
• Flourishing Families Early Intervention LLC
• Christopher Jordan Floyd, PT, DPT, OCS, ATC
• Foothills Chiropractic, LLC
• Margaret Anne Ford, M.A, CCC-SLP
• Forever Young Innovative Therapy Solutions, LLC
• Tanisha Forrest
• Haley Nicole Fortenberry, PT, DPT
• Deleah Foster, MA, LPC

• Oral and Maxillofacial Surgery (Dentist) in Simpsonville, SC
• Providers in Simpsonville, SC by specialty
• Oral and Maxillofacial Surgery (Dentist) in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.