Ft Mill Dentistry LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

FT MILL DENTISTRY LLC

Practice address

133 Clebourne St
Fort Mill, SC 29715-1742

Phone

(803) 547-7508

Fax

(803) 547-1070

NPI assigned

Sep 15, 2021

Organization subpart

No

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

Authorized official

Name

Ashley Dean

Title

Office Administrator

Phone

(803) 547-7508

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Fort Mill 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.

• Michael William Davis, D. M. D.

  • General Practice Dentistry
  • Fort Mill, SC
  • NPI 1750461083
  NPD (past)

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

{
    "created_epoch": "1631664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631664000000",
    "number": "1295405819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 489",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297160489",
            "telephone_number": "803-547-7508",
            "fax_number": "803-547-1070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 CLEBOURNE ST",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297151742",
            "telephone_number": "803-547-7508",
            "fax_number": "803-547-1070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FT MILL DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-15",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A",
        "authorized_official_last_name": "DEAN",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "803-547-7508"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTH CAROLINA BOARD OF DENTISTRY",
            "identifier": "4178",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTH CAROLINA BOARD OF DENTISTRY",
            "identifier": "4481",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fort Mill Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Chad Donald Frisch, D.C.
• From Roots to Wings Behavioral Consulting and Supervision, LLC
• Erica Frose, FNP
• Rachel Fry, RACHEL FRY
• Skylar Frye
• Aaliyah Fuller, CF SLP
• Joseph Funderburk, LMSW, LCSWA. RHIT
• Tammy Watts Furr, RN
• Anthony Joe Fusco, DMD
• Futuresmith Inc.

• General Practice Dentistry in Fort Mill, SC
• Providers in Fort Mill, 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 Sep 15, 2021; 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.