Falls Park Dentistry

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

FALLS PARK DENTISTRY

Practice address

104 N Main St
Greenville, SC 29601-2721

Phone

(864) 243-8371

NPI assigned

Apr 25, 2008

Last updated

Apr 25, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Brian Russell Derrick, D.M.D.NPI 1063566396

Title

Dentist/President

Phone

(864) 243-8371

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brian R Derrick, D.M.D

  • General Practice Dentistry
  • Greenville, SC
  • NPI 1063566396
  NPD (past) Authorized official

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

{
    "created_epoch": "1209081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209081600000",
    "number": "1790950202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 N MAIN ST",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012721",
            "telephone_number": "864-243-8371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 N MAIN ST",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012721",
            "telephone_number": "864-243-8371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FALLS PARK DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-25",
        "last_updated": "2008-04-25",
        "status": "A",
        "authorized_official_last_name": "DERRICK",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "RUSSELL",
        "authorized_official_title_or_position": "DENTIST/PRESIDENT",
        "authorized_official_telephone_number": "864-243-8371",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Faithful Hearts Homecare,LLC
• Monica Del Socorro Fajardo-Incer
• Emmanuel Andes Fajardo, MD
• Jori Falcon, DMD
• Lars Osmundson Falk
• Tabitha Livingston Fambrough
• Families Incorporated
• Families Incorporated
• Family Alliance Counseling Services, LLC
• Family C.a.R.E. Services, Inc.

• General Practice Dentistry in Greenville, SC
• Providers in Greenville, 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 Apr 25, 2008; 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.