Kevin B Fader, D.M.D.

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

Sex

Male

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 22, 2007.

{
    "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": []
}

• Helen Croasdale Eichelsbacher, MS CCC/SLP
• Elevated Health LLC
• Emily Van Buren Mulcahy PSYD
• Robyn Erickson
• Randall Brian Evans, MD
• Family Medicine of Hilton Head
• Christopher George Fisher, M.P.T.
• Laurie Ann Fisher, DPT
• Sara L Flood, OT
• Charles Frangos, LPC-MHSP

• All providers in Hilton Head, SC
• General Practice Dentistry in South Carolina

• 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.