Individual provider Active NPI

Dock Cleveland McDuffie III, D.D.S.

  • General Practice Dentistry
  • Rock Hill, SC
National Provider Identifier
1114984994
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3496 Issued in SC
Practice address
427 Dave Lyle Blvd S
Rock Hill, SC 29730-4402
Phone
(803) 328-0858
Fax
(803) 324-7748
NPI assigned
Apr 27, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3496 SC Primary

Addresses

Primary practice location

427 Dave Lyle Blvd S
Rock Hill, SC 29730-4402

Mailing address

427 Dave Lyle Blvd S
Rock Hill, SC 29730-4402
Phone (803) 328-0858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160531000013 SC Order and Referring Only - DentistPractitioner - Dentist 9638469992

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Family Dentistry, PC General Practice Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1114984994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "427 DAVE LYLE BLVD S",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297304402",
            "telephone_number": "803-328-0858",
            "fax_number": "803-324-7748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "427 DAVE LYLE BLVD S",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297304402",
            "telephone_number": "803-328-0858",
            "fax_number": "803-324-7748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDUFFIE",
        "first_name": "DOCK",
        "middle_name": "CLEVELAND",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "3496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

Verify at the official NPI Registry.