Mjbmfd LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8161 Issued in SC

Legal business name

MJBMFD LLC

Doing business as

Midlands Family Dentistry

Practice address

2844 Sunset Blvd
West Columbia, SC 29169-3420

Phone

(803) 731-0803

Fax

(803) 227-2844

NPI assigned

Jun 11, 2018

Last updated

Jun 11, 2018By the provider in NPPES

Organization subpart

Yes

Parent organization

MJBMFD LLCAs reported in NPPES

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

Authorized official

Name

Dr. Mark Judson Burns, DDS

Title

Agent

Phone

(803) 873-0272

Specialties & licenses 1

Addresses

Other names 1

• Midlands Family Dentistry Doing business as

Part of

Mjbmfd LLC

Locations

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

{
    "created_epoch": "1528675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528675200000",
    "number": "1396238606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2844 SUNSET BLVD",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291693420",
            "telephone_number": "803-731-0803",
            "fax_number": "803-227-2844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2844 SUNSET BLVD",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291693420",
            "telephone_number": "803-731-0803",
            "fax_number": "803-227-2844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MJBMFD LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MJBMFD LLC",
        "enumeration_date": "2018-06-11",
        "last_updated": "2018-06-11",
        "status": "A",
        "authorized_official_last_name": "BURNS",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "JUDSON",
        "authorized_official_title_or_position": "AGENT",
        "authorized_official_telephone_number": "803-873-0272",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "8161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Midlands Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in West Columbia, SC
• Providers in West Columbia, 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 11, 2018; 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.