Active NPI
Jeffrey Bradford Mokris, D.M.D., M.S.
- Orthodontics and Dentofacial Orthopedics Dentistry
- Fort Mill, SC
National Provider Identifier
1568625515
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 7002
- Practice address
- 1700 First Baxter Xing
Suite 201
Fort Mill, SC 29708-8948 - Phone
- (803) 547-0301
- NPI assigned
- Jul 9, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 7002 | SC | Primary |
Addresses
Primary practice location
1700 First Baxter Xing
Suite 201
Fort Mill, SC 29708-8948
Mailing address
3289 Richards Xing
Fort Mill, SC 29708-8910
Phone (803) 818-0783
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7002 | SC | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354579200000",
"number": "1568625515",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3289 RICHARDS XING",
"city": "FORT MILL",
"state": "SC",
"postal_code": "297088910",
"telephone_number": "803-818-0783"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 FIRST BAXTER XING",
"address_2": "SUITE 201",
"city": "FORT MILL",
"state": "SC",
"postal_code": "297088948",
"telephone_number": "803-547-0301"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOKRIS",
"first_name": "JEFFREY",
"middle_name": "BRADFORD",
"name_prefix": "Dr.",
"credential": "D.M.D., M.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-07-09",
"last_updated": "2012-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "SC",
"license": "7002",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Mill, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.