Three Fountains Family Dental Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2688 Issued in SC

Legal business name

THREE FOUNTAINS FAMILY DENTAL INC

Practice address

2248 Pine Street
West Columbia, SC 29170

Phone

(803) 755-0039

Fax

(803) 755-0007

NPI assigned

Nov 9, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Peter D Stoltz, DMD

Title

Dentist President

Phone

(803) 755-0039

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Brooke Manning Stoltz, DMD

  • Dentist
  • West Columbia, SC
  • NPI 1366531675
  NPD (past)
• Peter Otto Stoltz, DMD

  • Dentist
  • West Columbia, SC
  • NPI 1548359847
  NPD (past)

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295805042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2248 PINE STREET",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "29170",
            "telephone_number": "803-755-0039",
            "fax_number": "803-755-0007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2248 PINE STREET",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "29170",
            "telephone_number": "803-755-0039",
            "fax_number": "803-755-0007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THREE FOUNTAINS FAMILY DENTAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STOLTZ",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DENTIST PRESIDENT",
        "authorized_official_telephone_number": "803-755-0039",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "2688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kirsten Jordan Thompson, RPT
• Thornberry Counseling LLC
• Katherine Thornberry
• Tyler J Thornton, OD
• Letty Thottathil, MD
• Three Rivers Behavioral Care, LLC
• Three Rivers Behavioral Health LLC
• Three Rivers Behavioral Health LLC
• Three Rivers Behavioral Health LLC
• Three Rivers Midlands

• General Practice Dentistry in West Columbia, SC
• Providers in West Columbia, 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 Aug 22, 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.