R.E. Offutt, DDS, Ms and B.L. Cockerham DDS, MSP, PLLC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Legal business name

R.E. OFFUTT, DDS, MS AND B.L. COCKERHAM DDS, MSP, PLLC

Practice address

929 Market St
Fort Mill, SC 29708

Phone

(803) 547-0304

Fax

(704) 366-2639

NPI assigned

Sep 14, 2018

Organization subpart

No

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

Authorized official

Name

Richard Offutt, DDS

Title

Owner

Phone

(704) 366-2774

Specialties & licenses 1

Addresses

Other names 1

• Fort Mill Periodontics & Implant Dentistry Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bobby Lee Cockerham III, D.D.S, M.S.D

  • Periodontics
  • Charlotte, NC
  • NPI 1689969016
  NPD (past)

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

{
    "created_epoch": "1536883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537228800000",
    "number": "1275016263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6719 FAIRVIEW ROAD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28210",
            "telephone_number": "704-366-2774",
            "fax_number": "704-366-2639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 MARKET ST",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "29708",
            "telephone_number": "803-547-0304",
            "fax_number": "704-366-2639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "R.E. OFFUTT, DDS, MS AND B.L. COCKERHAM DDS, MSP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-14",
        "last_updated": "2018-09-18",
        "status": "A",
        "authorized_official_last_name": "OFFUTT",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-366-2774",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fort Mill Periodontics & Implant Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marjorie Nix Pusey
• Nicole Pytlinski, M.S., OTR/L
• Ying Qu
• Quarterman Dental Associates
• Queens Rheumatology LLC
• Corinne Leigh Race, RPH
• Jennifer F Radcliffe, LCSW, LISW-CP
• Malgorzata Ewa Radziszewska-Petros, NCAC II, AADC, CADC
• Sofia Ramirez, RBT
• Corey Alexander Raper, OT

• Periodontics in Fort Mill, SC
• Providers in Fort Mill, SC by specialty
• Periodontics in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2018; 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.