Welvista

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

WELVISTA

Doing business as

Clarendon Smiles for a Lifetime

Practice address

16 Weinberg St
Manning, SC 29102-2629

Phone

(803) 435-9555

Fax

(803) 435-9157

NPI assigned

Oct 18, 2006

Last updated

Sep 20, 2017By 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

Mrs. Georgia Bennett Famuliner

Title

Operations Director

Phone

(803) 584-4803

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Clarendon Smiles for a Lifetime Doing business as

Tax ID family

Welvista7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

• Welvista

  • Community/Retail Pharmacy
  • Columbia, SC
  • NPI 1023200441
  NPD tax ID
• Welvista

  • General Practice Dentistry
  • Varnville, SC
  • NPI 1023527348
  NPD tax ID
• Welvista

  dba Allendale Smiles for a Lifetime

  • General Practice Dentistry
  • Fairfax, SC
  • NPI 1033290937
  NPD tax ID
• Welvista

  dba Summerton Smiles for a Lifetime

  • General Practice Dentistry
  • Summerton, SC
  • NPI 1386727188
  NPD tax ID
• Welvista

  • Pharmacy
  • Columbia, SC
  • NPI 1861796518
  NPD tax ID
• Welvista

  dba Dillon Two Smiles for a Lifetime

  • General Practice Dentistry
  • Dillon, SC
  • NPI 1922189885
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jennifer L Glassey, DMD

  • Public Health Dentistry
  • Manning, SC
  • NPI 1053387605
  NPD (past)
• Darby Sexton Kelley, DMD

  • General Practice Dentistry
  • Manning, SC
  • NPI 1891852422
  NPD (past)

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505865600000",
    "number": "1619058591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 WEINBERG ST",
            "city": "MANNING",
            "state": "SC",
            "postal_code": "291022629",
            "telephone_number": "803-435-9555",
            "fax_number": "803-435-9157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 WEINBERG ST",
            "city": "MANNING",
            "state": "SC",
            "postal_code": "291022629",
            "telephone_number": "803-435-9555",
            "fax_number": "803-435-9157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELVISTA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2017-09-20",
        "status": "A",
        "authorized_official_last_name": "FAMULINER",
        "authorized_official_first_name": "GEORGIA",
        "authorized_official_middle_name": "BENNETT",
        "authorized_official_title_or_position": "OPERATIONS DIRECTOR",
        "authorized_official_telephone_number": "803-584-4803",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZA9561",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clarendon Smiles for a Lifetime",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Emily Way, RN
• Laine Blank Way
• Sara Welch, MA, CCC-SLP
• Derhonda K. Wells
• Sara Wells, REGISTERED NURSE
• Taylor Lott Whetstone
• Linda M White
• William C. Aldrich (Cypress Family Medicine)
• Bruce Barry Williams, D.O.
• Marva Denise Williams, MD

• General Practice Dentistry in Manning, SC
• Providers in Manning, 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 Sep 20, 2017; 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.