Organization Active NPI

Family Dentistry, PC

  • General Practice Dentistry
  • Rock Hill, SC
National Provider Identifier
1376683102
Registry record updated Jun 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3496 Issued in SC
Legal business name
FAMILY DENTISTRY, PC
Practice address
427 Dave Lyle Blvd S
Rock Hill, SC 29730-4402
Phone
(803) 328-0858
Fax
(803) 324-7748
NPI assigned
Feb 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2008

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

Authorized official

Name
Dr. Dock C. McDuffie,III, D.D.S.
Title
General Dentist
Phone
(803) 328-0858

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 3496 SC Primary

Addresses

Primary practice location

427 Dave Lyle Blvd S
Rock Hill, SC 29730-4402

Mailing address

427 Dave Lyle Blvd S
Rock Hill, SC 29730-4402
Phone (803) 328-0858

Other identifiers 1

IdentifierTypeStateIssuer
Z34963MedicaidSC

National Provider Directory

National Provider Directory

Locations

427 Dave Lyle Blvd S
Rock Hill, SC 29730
Phone (803) 328-0858

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1376683102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "427 DAVE LYLE BLVD S",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297304402",
            "telephone_number": "803-328-0858",
            "fax_number": "803-324-7748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "427 DAVE LYLE BLVD S",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297304402",
            "telephone_number": "803-328-0858",
            "fax_number": "803-324-7748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DENTISTRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "MCDUFFIE,III",
        "authorized_official_first_name": "DOCK",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "GENERAL DENTIST",
        "authorized_official_telephone_number": "803-328-0858",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "3496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Z34963",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; 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.