Individual provider Active NPI

Eric Satterlee, D.D.S.

  • General Practice Dentistry
  • Fort Mill, SC
National Provider Identifier
1831507359
Registry record updated Dec 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9517 Issued in SC
Practice address
130 Crisanto Ave Ste C
Fort Mill, SC 29715-6272
Phone
(803) 619-9100
Fax
(803) 265-3008
NPI assigned
Jul 28, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 109844 NC
General Practice Dentistry 1223G0001X 9517 SC Primary

Addresses

Primary practice location

130 Crisanto Ave Ste C
Fort Mill, SC 29715-6272

Mailing address

130 Crisanto Ave Ste C
Fort Mill, SC 29715-6272
Phone (803) 619-9100

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
109844NCMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1406505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1831507359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 CRISANTO AVE STE C",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297156272",
            "telephone_number": "803-619-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 CRISANTO AVE STE C",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297156272",
            "telephone_number": "803-619-9100",
            "fax_number": "803-265-3008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SATTERLEE",
        "first_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-28",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "109844",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "9517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Mill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.