DAN C FONG (NPI# 1114979002) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114979002 |
| Entity Type | Individual |
| Full Name | DAN C FONG |
| Credential | DDS |
| Practice Address |
4323 Hill St Columbia SC 29207-6022 |
| Practice Telephone | 8037515221 |
| Mailing Telephone | 8037515221 |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2016-06-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0700X |
Dentist Specialization: Prosthodontics |
41249 | CA | Dental Providers |
| Street Address |
4323 HILL ST |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29207-6022 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346855830 | Stephanie Catoni | Dentist | 4323 Hill St, Columbia, SC 29207-6022 | 2020-09-10 |
| 1750923140 | Siyi Wang | Dental Hygienist | 4323 Hill St, Columbia, SC 29207-6022 | 2019-10-17 |
| 1083266639 | Jordan E Broaddus | Dentist | 4323 Hill St, Columbia, SC 29207-6022 | 2019-07-14 |
| 1598321523 | Toria L Koutras | Dentist | 4323 Hill St, Columbia, SC 29207-6022 | 2019-05-15 |
| 1093370967 | David Allen Hornak | Student in an Organized Health Care Education/Training Program | 4323 Hill St, Columbia, SC 29207-6022 | 2019-05-07 |
| 1508429929 | Marilena Santiago | Dental Hygienist | 4323 Hill St, Columbia, SC 29207-6022 | 2019-04-22 |
| 1427524834 | Jane F Jones | Dental Hygienist | 4323 Hill St, Columbia, SC 29207-6022 | 2018-10-23 |
| 1568949170 | Latonya Teresa Stevenson-wright | Dental Hygienist | 4323 Hill St, Columbia, SC 29207-6022 | 2018-07-26 |
| 1912421843 | Peter Hutton Vogen | Dentist | 4323 Hill St, Columbia, SC 29207-6022 | 2017-08-02 |
| 1669996591 | Spencer Curtis Bevan | Dentist | 4323 Hill St, Columbia, SC 29207-6022 | 2017-08-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265043756 | Steven Mariani Rodriguez | Dentist | 5330 Moseby Street, Columbia, SC 29207 | 2020-08-10 |
| 1568082493 | Nichole Eckrich | Dentist | 5330 Moseby St., Columbia, SC 29207 | 2020-04-21 |
| 1730733007 | Forrest Wane Fullenkamp | Student in an Organized Health Care Education/Training Program | 5330 Moseby St, Columbia, SC 29207 | 2019-07-25 |
| 1306401625 | Kayla Anne Wolcott | Pharmacist | Moncrief Army Hospital Outpatient Pharmacy 1 Ft Jackson, Columbia, SC 29207 | 2019-05-02 |
| 1588145098 | Renetta Denise Green | Counselor | Fort Jackson/acs 9810 Lee St, Columbia, SC 29207 | 2018-08-23 |
| 1154814028 | Amanda Zelnick | Dentist | Bldg 5330 Moseby St, Ft Jackson, NC 29207 | 2018-06-14 |
| 1790231777 | Brittaney Elizabeth Anne Lewelling | Specialist/Technologist | 5975 Chesnut Road, Columbia, SC 29207 | 2016-08-30 |
| 1376749838 | Moncrief Army Community Hospital | Clinic/Center | 5330 Mosby Street, Fort Jackson, SC 29207 | 2007-06-22 |
| 1902002462 | Moncrief Army Community Hospital | Clinic/Center | 1890 Washington Road, Fort Jackson, SC 29207 | 2007-06-22 |
| 1730279860 | Donna L Briquet | Pharmacist | 4500 Marion Street, Columbia, SC 29207 | 2006-10-12 |
| Find all providers in zip 29207 | ||||
| Taxonomy Code | 1223P0700X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Prosthodontics |
| That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720230527 | George C. Whitaker | Dentist | 8815 Centre Park Dr, Columbia, MD 21045-2282 | 2008-10-13 |
| 1588732895 | Robert D Holland Jr. | Dentist | 4019 Forest Dr, Columbia, SC 29204-4313 | 2006-12-04 |
| 1922327048 | Mark John Sanders | Dentist | 10203 Tanager Ln, Columbia, MD 21044-3943 | 2010-05-28 |
| 1326248535 | Cindy B Nichols | Dentist | 10 Richland Medical Park Dr Ste A, Columbia, SC 29203-6892 | 2007-07-25 |
| 1538207170 | Michael Wright | Dentist | 10630 Little Patuxent Pkwy, Columbia, MD 21044-3264 | 2007-02-04 |
| 1376618371 | John F Burton | Dentist | 10 Richland Medical Park Dr, Columbia, SC 29203-6892 | 2006-11-22 |
| 1972615201 | John Cortland Stuart | Dentist | 6439 Garners Ferry Rd, Columbia, SC 29209-1638 | 2006-08-31 |
| 1437107356 | Richard V. Ritter | Dentist | 4323 Hill St, Columbia, SC 29207-6022 | 2006-05-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649818048 | Safa Tahmasebi | Dentist | 481 Munn Rd Ste 100, Fort Mill, SC 29715-0014 | 2019-12-16 |
| 1336657386 | Candice Marie Vinson | Dentist | 1149 Oakland Market Rd, Mount Pleasant, SC 29466-8220 | 2018-01-11 |
| 1316459753 | David W Richardson | Dentist | 765 St. Andrews Blvd., Charleston, SC 29407 | 2017-10-25 |
| 1831580620 | Bryan A Lara | Dentist | 110 Auston Woods Cir, Apt U, Easley, SC 29640-4301 | 2015-02-15 |
| 1497146906 | Palmetto Prosthodontics, LLC | Dentist | 145 Woodruff Place Cir, Simpsonville, SC 29681-3672 | 2015-02-05 |
| 1255631214 | Steven Gordon Lewis | Dentist | 481 Munn Rd, Suite 100, Fort Mill, SC 29715-8408 | 2010-10-25 |
| 1598929408 | Mayur Mahendra Patel | Dentist | 682 Johnnie Dodds Blvd, Suite 102, Mt Pleasant, SC 29464-3028 | 2008-07-10 |
| 1295999100 | Kenneth Steven Barrack | Dentist | 682 Johnnie Dodds Blvd Ste 102, Mt Pleasant, SC 29464-3028 | 2008-07-10 |
| 1487812327 | Virgil Vacarean | Dentist | 25 Clark Summit Dr Ste 100, Bluffton, SC 29910-4999 | 2008-05-28 |
| 1003086224 | Adam M Clark | Dentist | 1416 Ashley River Rd, Atlantic Aesthetics, Charleston, SC 29407-5306 | 2008-03-04 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.