Individual provider Active NPI

Brenda L Halsey, DDS

  • Dentist
  • Fort Mill, SC
National Provider Identifier
1285755785
Registry record updated Dec 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8466 Issued in SC
Practice address
1200 Gold Hill Rd Ste 101
Fort Mill, SC 29708-6916
Phone
(803) 396-0000
Fax
(803) 396-0001
NPI assigned
Apr 2, 2007
Last updated
Dec 29, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 8466 SC Primary
General Practice Dentistry 1223G0001X 7134 NC

Addresses

Primary practice location

1200 Gold Hill Rd Ste 101
Fort Mill, SC 29708-6916

Mailing address

1200 Gold Hill Rd Ste 101
Fort Mill, SC 29708-6916
Phone (803) 396-0000

Other practice location 1

201 Providence Rd
Charlotte, NC 28207-1464
Phone (704) 376-6470 ext. 2915

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
8466SCMDDentist
7134NCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeshore Dental LLC CurrentSince Oct 6, 2024 Accepting new patients
Armstrong & Eshleman, PA General Practice Past Accepting new patients

Locations

1200 Gold Hill Rd
#101
Fort Mill, SC 29708
Phone (803) 396-0000

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": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609200000000",
    "number": "1285755785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 GOLD HILL RD STE 101",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297086916",
            "telephone_number": "803-396-0000",
            "fax_number": "803-396-0001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 GOLD HILL RD STE 101",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297086916",
            "telephone_number": "803-396-0000",
            "fax_number": "803-396-0001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 Providence Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282071464",
            "country_code": "US",
            "telephone_number": "704-376-6470 x2915",
            "fax_number": "704-496-2915",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALSEY",
        "first_name": "BRENDA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-02",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "8466",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "7134",
            "primary": false
        }
    ],
    "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 Dec 29, 2020; 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.