Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Southlake Family Dentistry LLC

Organization General Practice Dentistry · NPI 1487670667

Southlake Family Dentistry LLC provides General Practice Dentistry in Fort Mill, South Carolina. Licensed in South Carolina. Registered with an NPI since 2006.

Licensed in
SC
In the registry since
2006
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1741 Gold Hill Rd Ste 2010
Fort Mill, SC 29708-8202 Not confirmed with CMS for 19 years — call before visiting
Phone: (803) 548-3342
Fax: (803) 548-3817
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 2588 (SC)
General Practice Dentistry Taxonomy 1223G0001X · Licence 3549 (SC)

Record details

NPI number1487670667
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Gary Kimsey — President · (803) 548-3342
NPI enumeratedJuly 14, 2006
Last updated in NPPESJuly 16, 2007
Mailing address1741 Gold Hill Rd, Suite 2010, Fort Mill, SC 29708-8202

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