Forth Dental Charleston, LLC

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

Legal business name

FORTH DENTAL CHARLESTON, LLC

Doing business as

J. Bradford Smith and Assoc

Practice address

454 Clemson Rd
Columbia, SC 29229-7925

Phone

(034) 623-6628

Fax

(803) 619-6053

NPI assigned

May 12, 2025

Last updated

May 12, 2025By 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

Deena Marie Phimvongsa, OPERATIONAL MANAGER

Title

Operations Manager

Phone

(702) 354-4569

Specialties & licenses 1

Addresses

Other names 1

• J. Bradford Smith and Assoc Doing business as

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

{
    "created_epoch": "1747008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747008000000",
    "number": "1447040431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "454 CLEMSON RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292297925",
            "telephone_number": "034-623-6628",
            "fax_number": "803-619-6053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "454 CLEMSON RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292297925",
            "telephone_number": "034-623-6628",
            "fax_number": "803-619-6053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORTH DENTAL CHARLESTON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-12",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A",
        "authorized_official_last_name": "PHIMVONGSA",
        "authorized_official_first_name": "DEENA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "702-354-4569",
        "authorized_official_credential": "OPERATIONAL MANAGER"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "J. Bradford Smith and Assoc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Caitlin Louise Forquer
• Jeanette Forrest
• Katherine Forslund, PSYD
• Owen Forsman, PT, DPT
• Joseph - Forte Jr., PA-C
• Marcus Fortson
• Makaylah Forty, RBT
• Erin Forward
• Stuart Foss, FNP
• Foster Orthodontics

• Public Health Dentistry in Columbia, SC
• Providers in Columbia, SC by specialty
• Public Health Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2025; 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.