Stephen W. Durham, D.M.D, P.A.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30-03440 Issued in SC

Practice address

223 Dayton School Rd
Suite 103
Easley, SC 29642-1447

Phone

(864) 306-8350

Fax

(864) 306-8587

NPI assigned

Jan 9, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Oct 17, 2013 through Oct 17, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Artistic Impressions Cosmetic and Family Dentistry, PA

  • General Practice Dentistry
  • Easley, SC
  • NPI 1639406390
  NPD (past)

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689723678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 DAYTON SCHOOL RD",
            "address_2": "SUITE 103",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296421447",
            "telephone_number": "864-306-8350",
            "fax_number": "864-306-8587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 DAYTON SCHOOL RD",
            "address_2": "SUITE 103",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296421447",
            "telephone_number": "864-306-8350",
            "fax_number": "864-306-8587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURHAM",
        "first_name": "STEPHEN",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "D.M.D, P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "30-03440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dsi Renal Inc (NRI Easley)
• Mary Beth Duncan, OTR/L
• Rosemary Duncan
• Michelle Dunn
• Isabel Grace Durham, PA-C
• Leah Catherine Durrance
• Thomas Robert Dyar, MD
• Deirdra Dyenson, CRNA
• Easley Community Healthcare, LLC (Powdersville Post Acute)
• Easley Dental Associates

• General Practice Dentistry in Easley, SC
• Providers in Easley, 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 Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.