CHARLESTON ORAL AND FACIAL SURGERY, INC. (NPI# 1043409063) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043409063 |
| Entity Type | Organization |
| Organization Name | CHARLESTON ORAL AND FACIAL SURGERY, INC. |
| Other Organization Name | CHARLESTON CENTER FOR ORAL & FACIAL SURGERY |
| Practice Address |
125 Wappoo Creek Dr Suite 1 Charleston SC 29412-2163 |
| Mailing Address |
125c Wappoo Creek Dr Suite 1 Charleston SC 29412-2163 |
| Practice Telephone | 8437629028 |
| Practice Fax Number | 8437629030 |
| Mailing Telephone | 8437629028 |
| Mailing Fax Number | 8437629030 |
| Enumeration Date | 2007-10-16 |
| Last Update Date | 2012-10-19 |
| Authorized Official Name | EDWARD R STRAUSS (OWNER) |
| Authorized Official Telephone | 8437629028 |
| Authorized Official Credential | DMD, MD |
| Is Organization Subpart | Y |
| Parent Organization Name | CHARLESTON ORAL AND FACIAL SURGERY |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
4006 | SC | Dental Providers |
| Other Name | Type Code |
|---|---|
| Charleston Center for Oral & Facial Surgery | Former Legal Business Name - Organization |
| Street Address |
125 WAPPOO CREEK DR SUITE 1 |
| City | CHARLESTON |
| State | SC |
| Zip Code | 29412-2163 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417203696 | Patrick Duffy Jr. | Psychologist | 125 Wappoo Creek Dr, Charleston, SC 29412-2163 | 2012-07-25 |
| 1245549096 | Active Life, LLC | Clinic/Center | 125 Wappoo Creek Dr, Suite 202, Charleston, SC 29412-2163 | 2010-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780219055 | Terra Rae Mchugh | Speech-Language Pathologist | 418 Folly Rd. Phc Rehab, Suite B, Charleston, SC 29412 | 2020-03-07 |
| 1437795747 | Brigitte Britt Huttemeyer | Nurse Practitioner | 678 Castle Pinckney Dr, Charleston, SC 29412 | 2019-11-21 |
| 1760956619 | Madison Culler, D.m.d., P.a. | Dentist | 211 Simmons Street, Mount Pleasant, SC 29412 | 2019-01-14 |
| 1366932717 | Harborview Speech Therapy, LLC | Speech-Language Pathologist | 783 Stebbins Street, Charleston, SC 29412 | 2018-05-11 |
| 1780193003 | Grace K Cotton | Speech-Language Pathologist | 1265 Marshview Dr, Charleston, SC 29412 | 2017-09-29 |
| 1639628449 | Matthew Husband | Occupational Therapist | 930 Folly Road, Suite B, Charleston, SC 29412 | 2016-09-22 |
| 1679941843 | Renee Poser | Pharmacist | 907 Folly Rd Suite A, James Island, SC 29412 | 2015-09-04 |
| 1508205717 | Amanda Marie Ashcraft | Dental Hygienist | 113 Wappoo Creek Drive Suite 5, James Island Dental Associates Pa, Charleston, SC 29412 | 2013-06-20 |
| 1104147818 | Glendolyn Harrison | Social Worker | 125e Wappoo Creek Drive, Suite 101e, Charleston, SC 29412 | 2010-06-16 |
| 1487986055 | Rachel E. Brunette | Physical Therapist | 418 B Folly Rd., Charleston, SC 29412 | 2010-02-08 |
| Find all providers in zip 29412 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356963508 | Clements Ferry Dentistry LLC | Dentist | 1951 Clements Ferry Rd Ste 201, Charleston, SC 29492-8325 | 2020-05-11 |
| 1851945497 | Kacy Wonder | Dentist | 173 Ashley Avenue Room 453 Msc 507, Charleston, SC 29425 | 2019-08-01 |
| 1205290764 | Sloan Rehder | Dentist | 2051 Sam Rittenberg Blvd, Charleston, SC 29407-4683 | 2016-04-11 |
| 1679954705 | Coafs Lab | Dentist | 125 Wappoo Creek Dr Ste C1, Charleston, SC 29412-2161 | 2015-06-15 |
| 1952798357 | Now Or Never 2011, LLC | Dentist | 2270 Ashley Crossing Dr Ste 175, Charleston, SC 29414-5863 | 2015-04-23 |
| 1124296470 | M. Stephen Brandon, Dds LLC | Dentist | 1051 Gardner Rd Ste B, Charleston, SC 29407-5747 | 2008-02-20 |
| 1659442309 | Edward Elias Howard | Dentist | 1321 Virginia St E, Charleston, WV 25301 | 2006-11-13 |
| 1376614024 | Richard Lee Howard | Dentist | 1321 Virginia St East, Charleston, WV 25301 | 2006-11-13 |
| 1568543619 | Francis Simons Hane Jr. | Dentist | 96 Jonathan Lucas, Charleston, SC 29425 | 2006-10-17 |
| 1114930062 | Gordon Scott Weaver | Dentist | 869 Oakwood Rd, Charleston, WV 25314-2057 | 2006-08-14 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 29412 |
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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.