Family Dental Health of Spring Valley North LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

FAMILY DENTAL HEALTH OF SPRING VALLEY NORTH LLC

Practice address

18 Office Park CT
Columbia, SC 29223-5947

Phone

(803) 788-7300

Fax

(864) 751-6387

NPI assigned

Nov 28, 2022

Organization subpart

Yes

Parent organization

FDH HOLDING LLCAs reported in NPPES

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

Authorized official

Name

Mrs. Beth Illsley

Title

Director of Insurance

Phone

(864) 282-1935

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1669593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673222400000",
    "number": "1831809144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 MEMORIAL DRIVE EXT STE 400",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296511850",
            "telephone_number": "864-282-1935",
            "fax_number": "864-751-6387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 OFFICE PARK CT",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292235947",
            "telephone_number": "803-788-7300",
            "fax_number": "864-751-6387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DENTAL HEALTH OF SPRING VALLEY NORTH LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FDH HOLDING LLC",
        "enumeration_date": "2022-11-28",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A",
        "authorized_official_last_name": "ILLSLEY",
        "authorized_official_first_name": "BETH",
        "authorized_official_title_or_position": "DIRECTOR OF INSURANCE",
        "authorized_official_telephone_number": "864-282-1935",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Family Dental Health Group LLC
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• Family Dental Health of Murray Landing LLC
• Family Dental Health of Seven Oaks LLC
• Family Dental Health of Spring Valley LLC
• Family Empowerment Services of SC, LLC
• Family First Transportation LLC
• Family Matters LLC
• Family Matters Psychotherapy LLC
• Family Medicine Centers of South Carolina

• General Practice Dentistry in Columbia, SC
• Providers in Columbia, 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 Jan 9, 2023; 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.