John Wesley Edmunds III, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9891 Issued in SC

Practice address

201 Church St
Clover, SC 29710-1008

Phone

(803) 222-7711

NPI assigned

May 28, 2021

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Joseph H Hourihan

  • General Practice Dentistry
  • Clover, SC
  • NPI 1063088847
  NPD

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

{
    "created_epoch": "1622160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622160000000",
    "number": "1780250084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1253 LAWRENCE RD",
            "city": "CLOVER",
            "state": "SC",
            "postal_code": "297107713",
            "telephone_number": "704-914-6538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 CHURCH ST",
            "city": "CLOVER",
            "state": "SC",
            "postal_code": "297101008",
            "telephone_number": "803-222-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMUNDS",
        "first_name": "JOHN",
        "middle_name": "WESLEY",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-28",
        "last_updated": "2021-05-28",
        "certification_date": "2021-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "9891",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SC BOARD OF DENTISTRY DENTAL LICENSE NUMBER",
            "identifier": "9891",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dragonfly Wellness Center, LLC
• Kimberly Hallman Drechsler, R. PH.
• Anna Dresdow, LPC
• Alan Dzhabiev
• East
• Nazila Eshraghi, DPM
• Brandon Fierro
• Beverly Frommel, CD
• Courtney Edward Gadonniex, RPH
• Jacqueline Shannon Galbraith

• General Practice Dentistry in Clover, SC
• Providers in Clover, 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 May 28, 2021; 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.