Dillon Family Dental Center PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

DILLON FAMILY DENTAL CENTER PC

Practice address

101 E Jackson St
Dillon, SC 29536-2421

Phone

(843) 774-7662

Fax

(843) 774-7920

NPI assigned

Jul 15, 2006

Last updated

Aug 22, 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. Keith A Fincannon, D.M.D.NPI 1164638383

Title

President

Phone

(843) 774-7662

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 3

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.

• Keith A Fincannon, D.M.D.

  • General Practice Dentistry
  • Dillon, SC
  • NPI 1164638383
  NPD (past) Authorized official
• Ronald Kent Bracey, D.M.D.

  • General Practice Dentistry
  • Dillon, SC
  • NPI 1235345331
  NPD (past)
• Daniel Walter Miller, Jr, D.M.D.

  • General Practice Dentistry
  • Dillon, SC
  • NPI 1609082734
  NPD (past)

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1942226386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E JACKSON ST",
            "city": "DILLON",
            "state": "SC",
            "postal_code": "295362421",
            "telephone_number": "843-774-7662",
            "fax_number": "843-774-7920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E JACKSON ST",
            "city": "DILLON",
            "state": "SC",
            "postal_code": "295362421",
            "telephone_number": "843-774-7662",
            "fax_number": "843-774-7920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DILLON FAMILY DENTAL CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FINCANNON",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-774-7662",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZA9907",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89088X",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dillon Adult Day Care LLC (Dillon Adult Day Care)
• Dillon Community Pharmacy, Inc.
• Dillon Community Pharmacy, Inc.
• Dillon County Free Medical Clinic
• Dillon Eyecare Associates LTD
• Dillon Family Medicine, P.a.
• Dillon Family Medicine, PA
• Dillon Family Pharmacy I (Dillon Family Pharmacy)
• Dillon Internal Medicine Associates PA
• Dillon School District Four

• General Practice Dentistry in Dillon, SC
• Providers in Dillon, 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 22, 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.