Apple Seeds Pediatric Dentistry of Five Forks, LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

APPLE SEEDS PEDIATRIC DENTISTRY OF FIVE FORKS, LLC

Practice address

216 Scuffletown Rd Ste E
Simpsonville, SC 29681-7296

Phone

(864) 642-4400

Fax

(864) 282-1955

NPI assigned

May 27, 2016

Last updated

Jan 9, 2023By the provider in NPPES

Organization subpart

Yes

Parent organization

FDH HOLDINGS, LLCAs reported in NPPES

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

Authorized official

Name

Mrs. Beth Louise Illsley

Title

Director of Insurance

Phone

(864) 282-1935

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1464307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673222400000",
    "number": "1467800714",
    "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": "216 SCUFFLETOWN RD STE E",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296817296",
            "telephone_number": "864-642-4400",
            "fax_number": "864-282-1955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APPLE SEEDS PEDIATRIC DENTISTRY OF FIVE FORKS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FDH HOLDINGS, LLC",
        "enumeration_date": "2016-05-27",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A",
        "authorized_official_last_name": "ILLSLEY",
        "authorized_official_first_name": "BETH",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "DIRECTOR OF INSURANCE",
        "authorized_official_telephone_number": "864-282-1935",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Sawyer Angalet, OTR/L
• Heather J. Angel, LPC
• Naa Ardua Annan
• Anna Marie Garcia Anolin, RPH
• Allyson Antigha, PHARMD
• Stefanie Araya
• Ana Sofia Arias Carmona
• Arisecare Home Services
• Lindsay Garrett Armstrong, CCC-SLP
• Arrows of Grace Counseling, LLC

• Pediatric Dentistry in Simpsonville, SC
• Providers in Simpsonville, SC by specialty
• Pediatric Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2023; 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.