Mirror Lake Family Dentistry PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4499 Issued in SC

Legal business name

MIRROR LAKE FAMILY DENTISTRY PA

Practice address

54A Pointe Cir
Greenville, SC 29615-3506

Phone

(864) 235-0175

NPI assigned

Apr 15, 2014

Organization subpart

No

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

Authorized official

Name

Dr. William Phillip Swinderman III, D.D.S.

Title

Dentist

Phone

(216) 287-8921

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Michael George Medcalf, DMD

  • General Practice Dentistry
  • Greenville, SC
  • NPI 1982711636
  NPD (past)

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

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398211200000",
    "number": "1366861437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54A POINTE CIR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296153506",
            "telephone_number": "864-235-0175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54A POINTE CIR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296153506",
            "telephone_number": "864-235-0175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRROR LAKE FAMILY DENTISTRY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-15",
        "last_updated": "2014-04-23",
        "status": "A",
        "authorized_official_last_name": "SWINDERMAN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "PHILLIP",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "216-287-8921",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "4499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katelyn C Mintz, DPT
• Fatima Fransheska Miranda, NP
• Anna Grace Mirando, MSP, CCC-SLP
• Seid Ali Akbar Mirmiran-Yazdy, MD
• Kimberly Miro, COTA
• Sameer Mishra
• Michelle Jenkins Missel, M.ED., LPC
• Mission Chiropractic, LLC
• Bharat R Mistry, DOCTOR OF OPTOMETRY
• Carol Rentz Mitchell, MSN

• General Practice Dentistry in Greenville, SC
• Providers in Greenville, 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 Apr 23, 2014; 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.