Individual provider Active NPI

Celeste A. Lantis, D.D.S.

  • Dentist
  • Fort Mill, SC
National Provider Identifier
1194012559
Registry record updated Jul 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
18501 Issued in TX
Practice address
2373 Len Patterson Rd Ste 103
Fort Mill, SC 29708-8266
Phone
(803) 752-0655
NPI assigned
Jul 6, 2011
Last updated
Jul 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 18501 TX Primary

Addresses

Primary practice location

2373 Len Patterson Rd Ste 103
Fort Mill, SC 29708-8266

Mailing address

PO Box 860036
Minneapolis, MN 55486-0036

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
18501TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Professional of South Carolina, P.C. PastSince Jul 25, 2021 Accepting new patients
Network Provider Associates, P.C. Dentist Past Accepting new patients

Organizations & group practices 2

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": "1309910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1194012559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 860036",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554860036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2373 LEN PATTERSON RD STE 103",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297088266",
            "telephone_number": "803-752-0655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANTIS",
        "first_name": "CELESTE",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-06",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "18501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Mill, SC

Sources for this page

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