Henk Johannes Grobbelaar, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DGD.10174 Issued in SC

Practice address

810 Brayden Pkwy
Ste 109
Fort Mill, SC 29708

Phone

(803) 810-1609

NPI assigned

Jun 3, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Fort Mill Smiles Dentistry, PC

  • General Practice Dentistry
  • Fort Mill, SC
  • NPI 1700451028
  NPD

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

{
    "created_epoch": "1654214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1871232033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12217 GREYMORE CT",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282772494",
            "telephone_number": "704-743-7522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 BRAYDEN PKWY",
            "address_2": "STE 109",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "29708",
            "telephone_number": "803-810-1609"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1726 E 7th St Ste B",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282042464",
            "country_code": "US",
            "telephone_number": "980-292-3681",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GROBBELAAR",
        "first_name": "HENK",
        "middle_name": "JOHANNES",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-03",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "13025",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "DGD.10174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Grier
• Danielle Nicole Griffin, MSN-FNP
• Kayla Griffis, P.T.A
• Emily Grimes
• Nicole Grippo-Leodis
• Gabrielle Groff, PT
• Christie L Grogan, SLP
• Courtney Guerrieri
• Olivia Guillen Blas, RBT
• Lisa Gunter, LCSW, LISW CP

• General Practice Dentistry in Fort Mill, SC
• Providers in Fort Mill, 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 Oct 13, 2022; 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.