Springfield Dentistry

Primary specialty

DentistTaxonomy code 122300000X

License

4508 Issued in SC

Legal business name

SPRINGFIELD DENTISTRY

Practice address

452 Mercantile Place
Fort Mill, SC 29715

Phone

(803) 548-0005

NPI assigned

Dec 21, 2016

Organization subpart

Yes

Parent organization

MARK KLOPENSTINE PCAs reported in NPPES

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

Authorized official

Name

Dr. Mark Klopenstine, D.D.S.

Title

President

Phone

(803) 548-0005

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Springfield Family Dentistry Other name

Part of

Mark Klopenstine PC

Locations

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

{
    "created_epoch": "1482278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482278400000",
    "number": "1730624115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "452 MERCANTILE PLACE",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "29715",
            "telephone_number": "803-548-0005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "452 MERCANTILE PLACE",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "29715",
            "telephone_number": "803-548-0005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRINGFIELD DENTISTRY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARK KLOPENSTINE PC",
        "enumeration_date": "2016-12-21",
        "last_updated": "2016-12-21",
        "status": "A",
        "authorized_official_last_name": "KLOPENSTINE",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "803-548-0005",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "SC",
            "license": "4508",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1223G0001X",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Springfield Family Dentistry",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Tamikya Kayla Staley, M.A., LPCI
• Lisa Anne Starnes, LPC

• Dentist in Fort Mill, SC
• Providers in Fort Mill, SC by specialty
• Dentist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2016; 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.