NPIMap

Organization Active NPI

Family Dental Health Group

  • General Practice Dentistry
  • Fort Mill, SC
National Provider Identifier
1609769710
Registry record updated May 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
FAMILY DENTAL HEALTH GROUP
Practice address
1860 Coltharp Rd
Fort Mill, SC 29715-8978
Phone
(803) 802-7878
NPI assigned
May 29, 2025
Organization subpart
Yes
Parent organization
FDH HOLDINGS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 29, 2025

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

Authorized official

Name
Mrs. Beth Louise Illsley
Title
Insurance Director
Phone
(864) 282-1935

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

1860 Coltharp Rd
Fort Mill, SC 29715-8978

Mailing address

400 Memorial Drive Ext Ste 400
Greer, SC 29651-1850
Phone (864) 282-1935

Other names 1

  • Family Dental Health of Fort Mill Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Family Dental Health Group LLC31 organizations share this tax ID, including this one

Other organizations with this tax ID 30

Organizations that report the same tax identification number in the National Provider Directory.

View all 30

Locations

1860 Coltharp Rd
Fort Mill, SC 29715
Phone (803) 802-7878

NPI Registry JSON

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

{
    "created_epoch": "1748476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748476800000",
    "number": "1609769710",
    "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": "1860 COLTHARP RD",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297158978",
            "telephone_number": "803-802-7878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DENTAL HEALTH GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FDH HOLDINGS LLC",
        "enumeration_date": "2025-05-29",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "status": "A",
        "authorized_official_last_name": "ILLSLEY",
        "authorized_official_first_name": "BETH",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "INSURANCE DIRECTOR",
        "authorized_official_telephone_number": "864-282-1935",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Dental Health of Fort Mill",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 29, 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.