Michelle Dyer, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2022005557 Issued in MO

Practice address

137 Border Ave
Simpsonville, SC 29680-7388

Phone

(258) 505-5617

NPI assigned

Jun 23, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1624406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717200000000",
    "number": "1457920423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 ESTES DR",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633045502",
            "telephone_number": "248-505-5617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 BORDER AVE",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296807388",
            "telephone_number": "258-505-5617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYER",
        "first_name": "MICHELLE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-23",
        "last_updated": "2024-06-01",
        "certification_date": "2024-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "9930",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2022005557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Simpsonville, SC
• Providers in Simpsonville, 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 1, 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.