David Phelps, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3795 Issued in SC

Practice address

3904 Highway 86
Easley, SC 29642-9549

Phone

(864) 850-9100

NPI assigned

Jun 13, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Dec 24, 2015 through Dec 24, 2027

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.

• Southern Oaks Family Dentistry, PA

  • General Practice Dentistry
  • Easley, SC
  • NPI 1831356021
  NPD (past) Authorized official

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188259200000",
    "number": "1891790226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3904 HIGHWAY 86",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296429549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3904 HIGHWAY 86",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296429549",
            "telephone_number": "864-850-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELPS",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2007-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "3795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caryn Nix Petratos, R. PH.
• PH Health Care Services Inc
• PH Healthcare Services, Inc.
• Phong Thanh Phan, M.D.
• Phases Counseling Collective LLC
• Courtney Wingo Phillips, PA-C
• Myra Aurelia Phipps, M.D.
• Physical Therapy Consultants
• Pickens County Board of Disabilities and Special Needs
• Pickens County Commission on Alcohol & Drug Abuse

• General Practice Dentistry in Easley, SC
• Providers in Easley, 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 Aug 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.