David M Decillis, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2611 Issued in SC

Practice address

114 N Main Street
Heath Springs, SC 29058-0455

Phone

(803) 273-9336

Fax

(803) 273-3202

NPI assigned

Jan 19, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Heath Springs Dental Associates, P.a.

  • General Practice Dentistry
  • Heath Springs, SC
  • NPI 1306999602
  NPD (past) Authorized official

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265585749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 N MAIN STREET",
            "address_2": "P O BOX 455",
            "city": "HEATH SPRINGS",
            "state": "SC",
            "postal_code": "290580455",
            "telephone_number": "803-273-9336",
            "fax_number": "803-273-3202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 N MAIN STREET",
            "city": "HEATH SPRINGS",
            "state": "SC",
            "postal_code": "290580455",
            "telephone_number": "803-273-9336",
            "fax_number": "803-273-3202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECILLIS",
        "first_name": "DAVID",
        "middle_name": "M",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "2611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ifediora Foster Afulukwe, MD
• Clarence Campbell III, FNP
• Children First Medical Center
• Tyana Cunningham
• Heath Springs Dental Associates, P.a.
• Mollie Annette Hendrix, ATC
• Hsrcc Services, LLC (Heath Springs Residential Care Center)
• Stephen Lewis McDaniel
• Metrolyna Health Care LLC (Heath Springs Medical Center)

• General Practice Dentistry in Heath Springs, SC
• Providers in Heath Springs, 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 Jul 8, 2007; 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.