Fleetwood Square Dental, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

FLEETWOOD SQUARE DENTAL, LLC

Practice address

105 Fleetwood Dr
Easley, SC 29640-2019

Phone

(864) 855-2788

Fax

(864) 855-2689

NPI assigned

Aug 11, 2020

Last updated

Aug 11, 2020By 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. Sonia Kakkar, DDSNPI 1346302049

Title

MBR

Phone

(864) 855-2788

Specialties & licenses 1

Addresses

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.

• Sonia Kakkar, DDS

  • Dentist
  • Easley, SC
  • NPI 1346302049
  Authorized official Same address or phone

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

{
    "created_epoch": "1597104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597104000000",
    "number": "1831700178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 FLEETWOOD DR",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296402019",
            "telephone_number": "864-855-2788",
            "fax_number": "864-855-2789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 FLEETWOOD DR",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296402019",
            "telephone_number": "864-855-2788",
            "fax_number": "864-855-2689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLEETWOOD SQUARE DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-11",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A",
        "authorized_official_last_name": "KAKKAR",
        "authorized_official_first_name": "SONIA",
        "authorized_official_title_or_position": "MBR",
        "authorized_official_telephone_number": "864-855-2788",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gary Fisher
• Stephanie Fisher, PA
• Fleetwood Dental
• Fleetwood Internal Medicine PA
• Fleetwood Rehabilitation and Healthcare Center, LLC
• Elizabeth Alice Floyd, RN
• Foothills Bariatric and Wellness Center
• Foothills Cardiology Associates PA
• Foothills Community Health Care, Inc (Foothills Easley Pharmacy)
• Foothills Community Health Care, Inc. (Foothills Community Health Care Easley)

• Dental Clinic/Center in Easley, SC
• Providers in Easley, SC by specialty
• Dental Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2020; 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.