NPIMap

Organization Active NPI

Family Dental Health of Murray Landing LLC

  • General Practice Dentistry
  • Columbia, SC
National Provider Identifier
1386382695
Registry record updated Sep 11, 2024
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Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
FAMILY DENTAL HEALTH OF MURRAY LANDING LLC
Practice address
1612 Lake Murray Blvd
Columbia, SC 29212-8623
Phone
(803) 529-1319
NPI assigned
May 25, 2022
Last updated
Sep 11, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
FDH HOLDINGS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Authorized official

Name
Mrs. Beth Illsley
Title
Director of Insurance
Phone
(864) 282-1935

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

1612 Lake Murray Blvd
Columbia, SC 29212-8623

Mailing address

400 Memorial Drive Ext Ste 400
Greer, SC 29651-1850
Phone (864) 282-1935

National Provider Directory

National Provider Directory

Locations

1612 Lake Murray Blvd
Columbia, SC 29212
Phone (803) 407-6511

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1653436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726012800000",
    "number": "1386382695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 MEMORIAL DRIVE EXT STE 400",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296511850",
            "telephone_number": "864-282-1935",
            "fax_number": "864-751-6387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1612 LAKE MURRAY BLVD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292128623",
            "telephone_number": "803-529-1319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DENTAL HEALTH OF MURRAY LANDING LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FDH HOLDINGS LLC",
        "enumeration_date": "2022-05-25",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A",
        "authorized_official_last_name": "ILLSLEY",
        "authorized_official_first_name": "BETH",
        "authorized_official_title_or_position": "DIRECTOR OF INSURANCE",
        "authorized_official_telephone_number": "864-282-1935",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; 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.