NPIMap

Organization Active NPI

Family Dental Health Group LLC

Doing business as Family Dental Health of Lake Carolina

  • General Practice Dentistry
  • Columbia, SC
National Provider Identifier
1679443717
Registry record updated Nov 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
FAMILY DENTAL HEALTH GROUP LLC
Doing business as
Family Dental Health of Lake Carolina
Practice address
5 Lake Carolina Way Ste 210
Columbia, SC 29229-7563
Phone
(803) 736-8606
NPI assigned
Nov 5, 2025
Last updated
Nov 5, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
FDH HOLDINGS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 5, 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
Director of Insurance
Phone
(864) 282-1935

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

5 Lake Carolina Way Ste 210
Columbia, SC 29229-7563

Mailing address

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

Other names 1

  • Family Dental Health of Lake Carolina 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

5 Lake Carolina Way
Ste 210
Columbia, SC 29229
Phone (803) 736-8606

400 Memorial Drive Ext
Greer, SC 29651

NPI Registry JSON

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

{
    "created_epoch": "1762300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762300800000",
    "number": "1679443717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 MEMORIAL DRIVE EXT",
            "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": "5 LAKE CAROLINA WAY STE 210",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292297563",
            "telephone_number": "803-736-8606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DENTAL HEALTH GROUP LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FDH HOLDINGS, LLC",
        "enumeration_date": "2025-11-05",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "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": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Dental Health of Lake Carolina",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.