Dental Wellness Center of Fort Mill, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

DENTAL WELLNESS CENTER OF FORT MILL, LLC

Practice address

749 Stockbridge Dr
Fort Mill, SC 29708-7200

Phone

(888) 885-8492

NPI assigned

Mar 8, 2019

Last updated

Jun 11, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Christie D Lawrence

Title

Corporate Operations Coordinator

Phone

(912) 920-5577

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1552003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1245798230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60339",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314200339",
            "telephone_number": "912-920-5577",
            "fax_number": "912-226-3489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "749 STOCKBRIDGE DR",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297087200",
            "telephone_number": "888-885-8492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL WELLNESS CENTER OF FORT MILL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-08",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE",
        "authorized_official_first_name": "CHRISTIE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CORPORATE OPERATIONS COORDINATOR",
        "authorized_official_telephone_number": "912-920-5577",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "DN010747",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1497918759",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charlotte Demartino, BT
• Dina Demeo
• Dental Professional of South Carolina, P.C. (Dental Care at Mills Crossing)
• Dental Professionals of SC, PC (West Town Dental Care)
• Dental Wellness Center Eb5 Investment VI LLC (Angel Dental Fort Mill)
• Vanessa Derado, BT
• Brandes Dey, DPT
• Diabetes Endocrinology & Metabolism Associates, PA
• Bennie Gloria Diamond, MD
• Diane O'Neill Lisw LLC

• Dental Clinic/Center in Fort Mill, SC
• Providers in Fort Mill, SC by specialty
• Dental Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.