Rhiannon Fullenkamp, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

10154 Issued in SC

Practice address

1099 N Main St # 102
Summerville, SC 29483-7300

Phone

(843) 536-8577

NPI assigned

May 10, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Rhiannon Perez Former name

Medicare fee-for-service enrollment

Enrolled in SC

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

Locations

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

• Summerville Smiles Dental Office, PC

  • General Practice Dentistry
  • Summerville, SC
  • NPI 1972179307
  NPD

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

{
    "created_epoch": "1652140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652140800000",
    "number": "1689310831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 WESCOTT CT",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294035704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1099 N MAIN ST # 102",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294837300",
            "telephone_number": "843-536-8577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLENKAMP",
        "first_name": "RHIANNON",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-10",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "10154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RHIANNON",
            "last_name": "PEREZ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Heidi N Fries
• Brian Charles Froehly, D.C.
• Angelique Frost
• Christina L Frum
• Roland Kirk Fulcher, DMD
• G & J Enterprises of S'Ville Inc
• Cherika Stephanie Gadson, NP-C
• Renonna Kay Gagnon, LMT
• Sarah Sheldon Gaillard, M.S., CCC-SLP
• Vergena Pearl Gainey, RBT

• Dentist in Summerville, SC
• Providers in Summerville, SC by specialty
• Dentist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2022; 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.