Jonathan Alexander Fernandez, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DGD.10207 Issued in SC

Practice address

1000 Pine Top Rd
Belton, SC 29627-9539

Phone

(864) 338-6589

NPI assigned

Jun 6, 2022

Last updated

Jun 6, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Carolina Oaks Belton LLC

  dba Belton Comprehensive Dentistry

  • General Practice Dentistry
  • Belton, SC
  • NPI 1407727365
  NPD
• Belton Comprehensive Dentistry

  • General Practice Dentistry
  • Belton, SC
  • NPI 1588802680
  NPD (past)

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

{
    "created_epoch": "1654473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1356070445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 OLD MILL RD",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296429501",
            "telephone_number": "864-991-7302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 PINE TOP RD",
            "city": "BELTON",
            "state": "SC",
            "postal_code": "296279539",
            "telephone_number": "864-338-6589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "JONATHAN",
        "middle_name": "ALEXANDER",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-06",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "DGD.10207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• John Paul Davis, LMT
• Cortney Shantres Ellis
• Alyssa Danielle Erskine, PHARMD
• Family Care Management, LLC
• Rachell Gaines
• Jarod Roy Haggard, DC
• Heart to Heart Therapeutic Services Inc
• Kenneth Bryan Heller, MD
• Home Care Medical AIDS Inc

• General Practice Dentistry in Belton, SC
• Providers in Belton, 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 Jun 6, 2022; 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.