Roy Lee Faulks III, DMD, MSD

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

11148 Issued in SC

Practice address

3527 Bush River Rd
Columbia, SC 29210-4805

Phone

(803) 798-0894

NPI assigned

Apr 21, 2021

Last updated

Jul 20, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Columbia Periodontal Assoicates, LLC

  • Periodontics
  • Columbia, SC
  • NPI 1548282130
  NPD (past)
• Sandhills Periodontics

  • Periodontics
  • Columbia, SC
  • NPI 1053800623
  NPD (past)

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

{
    "created_epoch": "1618963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752969600000",
    "number": "1639751571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3527 BUSH RIVER RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292104805",
            "telephone_number": "803-798-0894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3527 BUSH RIVER RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292104805",
            "telephone_number": "803-798-0894"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "456 Clemson Rd",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292297925",
            "country_code": "US",
            "telephone_number": "803-788-9715",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2325 Devine St",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292052403",
            "country_code": "US",
            "telephone_number": "803-252-2844",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAULKS",
        "first_name": "ROY",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DMD, MSD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-21",
        "last_updated": "2025-07-20",
        "certification_date": "2025-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "SC",
            "license": "11148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fast Trac Transportation Inc (Fast Trac Ambulance Service)
• Allison Faulconer
• Jessica I Faulk, MS, RD
• Rebecca C. Faulk, OTR/L
• Shannon Barnes Faulkenberry, PHARMD
• Sarah Faulks
• Vincent Faulks, RBT
• Shamonique Favor, CNA
• Wajiha Fayyaz
• FC Midlands Kathwood, LLC (Carolina Gardens at Kathwood)

• Periodontics in Columbia, SC
• Providers in Columbia, SC by specialty
• Periodontics in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.