Modern Dental Care

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

MODERN DENTAL CARE

Practice address

3420 Filbert Hwy
Clover, SC 29710-5602

Phone

(803) 286-6455

NPI assigned

Apr 27, 2021

Last updated

Apr 27, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Irina Fridman

Title

Business Administration

Phone

(803) 286-6455

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1619481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619481600000",
    "number": "1376125518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3420 FILBERT HWY",
            "city": "CLOVER",
            "state": "SC",
            "postal_code": "297105602",
            "telephone_number": "803-286-6455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3420 FILBERT HWY",
            "city": "CLOVER",
            "state": "SC",
            "postal_code": "297105602",
            "telephone_number": "803-286-6455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-27",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A",
        "authorized_official_last_name": "FRIDMAN",
        "authorized_official_first_name": "IRINA",
        "authorized_official_title_or_position": "BUSINESS ADMINISTRATION",
        "authorized_official_telephone_number": "803-286-6455"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elanie Deshea Martens, FNP-BC
• Cierra Marie Martinez
• Scottie Ann McClure
• Anna Grace McLaughlin, LISW-CP, LCSW
• Tara Mehta, PH.D.
• Lachelle Hendley Moore, DMD
• Catherine Joanna Myrick, D.M.D.
• Ernest Lloyd Myrick Jr., D.M.D.
• New Beginnings Behavioral Health
• Tatum Newbill

• Dental Clinic/Center in Clover, SC
• Providers in Clover, SC by specialty
• Dental Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 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.