DR. SCOTT C WIETECHA (NPI# 1114092707) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114092707 |
| Entity Type | Individual |
| Full Name | DR. SCOTT C WIETECHA |
| Credential | DMD |
| Practice Address |
7033 Saint Andrews Rd Suite 102 Columbia SC 29212-1179 |
| Practice Telephone | 8037813321 |
| Practice Fax Number | 8037814406 |
| Mailing Telephone | 8037813321 |
| Mailing Fax Number | 8037814406 |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
2148 | SC | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | DENTAL LICENSE | 2148 | 01 |
| SC | ZZ2148 | 05 |
| Street Address |
7033 SAINT ANDREWS RD SUITE 102 |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29212-1179 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073585204 | John A Rider | Pediatrics | 7033 Saint Andrews Rd, Columbia, SC 29212-1179 | 2006-02-02 |
| 1053506980 | Center for Plastic Surgery | Plastic Surgery | 7033 Saint Andrews Rd, Suite 204, Columbia, SC 29212-1179 | 2007-09-13 |
| 1235261157 | Rachel Payne | Nurse Practitioner | 7033 Saint Andrews Rd, Columbia, SC 29212-1179 | 2007-03-09 |
| 1548335136 | Associates In Oral & Maxillofacial Surgery, Pa | Dentist | 7033 Saint Andrews Rd, Suite 102, Columbia, SC 29212-1179 | 2006-11-21 |
| 1578638177 | Isaac E Davis IIi | Dentist | 7033 Saint Andrews Rd, Suite 102, Columbia, SC 29212-1179 | 2006-11-21 |
| 1710052311 | Charles M Miyaji | Dentist | 7033 Saint Andrews Rd, Suite 102, Columbia, SC 29212-1179 | 2006-11-21 |
| 1417022914 | James E Mercer | Dentist | 7033 Saint Andrews Rd, Suite102, Columbia, SC 29212-1179 | 2006-11-21 |
| 1902980162 | Meredith K Rychener | Physical Therapist | 7033 Saint Andrews Rd, Suite 203, Columbia, SC 29212-1179 | 2006-10-24 |
| 1508873019 | Gerald A Fishman | Family Medicine | 7033 Saint Andrews Rd, Ste205, Columbia, SC 29212-1179 | 2006-08-01 |
| 1699708347 | Lexington County Health Services District, Inc. | Obstetrics & Gynecology | 7033 Saint Andrews Rd, Ste 305, Columbia, SC 29212 | 2006-07-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245758887 | Amanda Gail Holloman | Pharmacist | 6021 St. Andrews Road, Columbia, SC 29212 | 2017-09-04 |
| 1578080180 | Alvin Mitchell Jr. | Non-emergency Medical Transport (VAN) | 10 Breezewood Court, Columbia, SC 29212 | 2017-08-24 |
| 1467975102 | Shelby Clemmer | Behavior Technician | 2 Harbison Way, Columbia, SC 29212 | 2017-07-25 |
| 1982149019 | Showntellem | Private Vehicle | 336 Foxfire Dr, Columbia, SC 29212 | 2016-12-28 |
| 1902215296 | Miranda Willis Adult Day Care, LLC | Social Worker | 5932 Mcmillian Circle, Columbia, SC 29212 | 2014-08-12 |
| 1013342591 | Robert Glendon Long | Pediatrics | 15 Woodpine Ct, Columbia, SC 29212 | 2013-09-04 |
| 1174969638 | Melinda Dumas Crenshaw | Psychologist | 2800 Ashland Rd., Columbia, SC 29212 | 2013-05-10 |
| 1417209982 | Physician Services LLC | Internal Medicine | 214 Lake Front Drive, Physician Services, Cola, SC 29212 | 2012-10-09 |
| 1306131800 | Rocky Mountain Holdings LLC | Ambulance | 6015 Saint Andrews Rd, Columbia, SC 29212 | 2011-06-13 |
| 1023262839 | Candace Anne Aguiar | Nurse Anesthetist, Certified Registered | 400 Palmetto Health Pkwy, Palmetto Health Baptist Parkridge, Columbia, SC 29212 | 2008-11-06 |
| Find all providers in zip 29212 | ||||
| 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 |
|---|---|---|---|---|
| 1740810845 | Akeso Columbia Office LLC | Dentist | 6798 Oak Hall Ln Ste A-1, Columbia, MD 21045-4892 | 2020-01-17 |
| 1679809958 | Mathew K Woodward | Dentist | 5397 Twin Knolls Rd Ste 18, Columbia, MD 21045-3256 | 2009-10-21 |
| 1679730709 | Antoine Gerard Johnson | Dentist | 8860 Columbia 100 Pkwy Ste 308, Columbia, MD 21045-2298 | 2008-05-16 |
| 1497829311 | Darren Richard Cross | Dentist | 611 Oneil Ct, Columbia, SC 29223-7656 | 2006-11-20 |
| 1427121078 | Joseph John Krupa IIi | Dentist | 3304 Forest Dr, Columbia, SC 29204-4024 | 2006-11-15 |
| 1194748285 | Paul Edward Cullum | Dentist | 105 Berrywood Dr, Columbia, TN 38401-6409 | 2006-07-26 |
| 1508885682 | Michael Illar Muul | Dentist | 6798 Oak Hall Ln, Suite A1, Columbia, MD 21045-4892 | 2006-07-19 |
| 1952353732 | James Winston Strider Jr. | Dentist | 9310 Two Notch Road, Columbia, SC 29223 | 2006-05-17 |
| 1952376964 | Timothy Thomas Coyle | Dentist | 3015 S Providence Rd, Suite 5, Columbia, MO 65203 | 2006-02-22 |
| 1497720841 | George Alan Hurwitz | Dentist | 10782 Hickory Ridge Rd, Columbia, MD 21044-3646 | 2006-02-21 |
| Find all providers in COLUMBIA | ||||
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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.