Individual provider Active NPI

Kevin B Fader, D.M.D.

  • General Practice Dentistry
  • Hilton Head, SC
National Provider Identifier
1740282185
Registry record updated Aug 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4235 Issued in SC
Practice address
2 Corpus Christie PL
Professional Building Ste. 202
Hilton Head, SC 29928-1700
Phone
(843) 842-3555
Fax
(843) 341-3987
NPI assigned
Aug 15, 2005
Last updated
Aug 22, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4235 SC Primary

Addresses

Primary practice location

2 Corpus Christie PL
Professional Building Ste. 202
Hilton Head, SC 29928-1700

Mailing address

2 Corpus Christie PL
Professional Building Ste. 202
Hilton Head, SC 29928-1700
Phone (843) 842-3555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4235SCMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187740800000",
    "number": "1740282185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CORPUS CHRISTIE PL",
            "address_2": "PROFESSIONAL BUILDING STE. 202",
            "city": "HILTON HEAD",
            "state": "SC",
            "postal_code": "299281700",
            "telephone_number": "843-842-3555",
            "fax_number": "843-341-3987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CORPUS CHRISTIE PL",
            "address_2": "PROFESSIONAL BUILDING STE. 202",
            "city": "HILTON HEAD",
            "state": "SC",
            "postal_code": "299281700",
            "telephone_number": "843-842-3555",
            "fax_number": "843-341-3987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FADER",
        "first_name": "KEVIN",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2007-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "4235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hilton Head, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2007; 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.