R Mathis 002 LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

R MATHIS 002 LLC

Practice address

2830 Reidville Rd
Spartanburg, SC 29301-5640

Phone

(864) 574-0762

NPI assigned

Nov 19, 2019

Organization subpart

No

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

Authorized official

Name

Dallas Burnett

Title

Ceo

Phone

(864) 415-0931

Specialties & licenses 1

Addresses

Other names 1

• Foothills Dental Doing business as

Locations

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

{
    "created_epoch": "1574121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635984000000",
    "number": "1124664743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 N GROVE MEDICAL PARK DR",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293034222",
            "telephone_number": "864-310-6888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2830 REIDVILLE RD",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293015640",
            "telephone_number": "864-574-0762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "R MATHIS 002 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-19",
        "last_updated": "2021-11-04",
        "certification_date": "2021-10-18",
        "status": "A",
        "authorized_official_last_name": "BURNETT",
        "authorized_official_first_name": "DALLAS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "864-415-0931"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Foothills Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Foothills Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Candace Soddu Quinn, LMSW
• Mark Eric Quinn, D.C.
• Michael Neal Quinn, DC
• Sean Quinn, RPH, PHARMD
• Joana Quintero
• R&R Futures LLC
• Diana Alexis Rabade, APRN
• Matthew Rabalais, ATC, CES, FMS
• Rachel E. Arthur, OT, LLC
• Radhey, LLC

• General Practice Dentistry in Spartanburg, SC
• Providers in Spartanburg, 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 Nov 4, 2021; 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.