Tatum Newbill

Primary specialty

DentistTaxonomy code 122300000X

License

11257 Issued in SC

Practice address

244 Latitude LN Ste 103
Clover, SC 29710-8125

Phone

(803) 831-2171

NPI assigned

Mar 30, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Carolina Family Dentistry at Lake Wylie

  • Dental Clinic/Center
  • Lake Wylie, SC
  • NPI 1629749106
  NPD (past)
• Modlin & Londry Xvi DDS LLC

  • General Practice Dentistry
  • Lake Wylie, SC
  • NPI 1508733825
  NPD (past)

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

{
    "created_epoch": "1585526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769644800000",
    "number": "1215565833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18228 MCKEE RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282780154",
            "telephone_number": "540-420-7595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "244 LATITUDE LN STE 103",
            "city": "CLOVER",
            "state": "SC",
            "postal_code": "297108125",
            "telephone_number": "803-831-2171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWBILL",
        "first_name": "TATUM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-30",
        "last_updated": "2026-01-29",
        "certification_date": "2026-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "59121168",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "12014",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "11257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Modern Dental Care
• Lachelle Hendley Moore, DMD
• Catherine Joanna Myrick, D.M.D.
• Ernest Lloyd Myrick Jr., D.M.D.
• New Beginnings Behavioral Health
• Marcia Lynne Nibert, D.C., LAC
• Novant Medical Group, Inc.
• Simren Patel, PA-C
• Marion Patterson
• Abhinaya Muralidharan Perumbedu

• Dentist in Clover, SC
• Providers in Clover, SC by specialty
• Dentist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.