FOOTHILLS ORAL & FACIAL SURGERY (NPI# 1134549629) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134549629 |
| Entity Type | Organization |
| Organization Name | FOOTHILLS ORAL & FACIAL SURGERY |
| Practice Address |
301 W Beltline Blvd #301 Anderson SC 29625-1505 |
| Practice Telephone | 8649674000 |
| Practice Fax Number | 8643289907 |
| Mailing Telephone | 8649674000 |
| Mailing Fax Number | 8643289907 |
| Enumeration Date | 2014-04-23 |
| Last Update Date | 2014-04-23 |
| Authorized Official Name | VICTOR P LEBEDOVYCH (PRESIDENT/CEO) |
| Authorized Official Telephone | 8649674000 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
4084 | SC | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 1223S0112X | 05 |
| Street Address |
301 W BELTLINE BLVD #301 |
| City | ANDERSON |
| State | SC |
| Zip Code | 29625-1505 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629554704 | Kathryn Moules Newton | Registered Nurse | 200 Mcgee Ed., Anderson, SC 29625 | 2018-07-12 |
| 1285121640 | Linda Reeves Mccullough | Registered Nurse | 1014bwhitehall Rd., Anderson, SC 29625 | 2018-04-20 |
| 1245688787 | Sacred Heart Beats | Music Therapist | 1107 Watkins Road, Anderson, SC 29625 | 2016-05-25 |
| 1649667718 | Deanna R Luvene | Counselor | 515b Camson Road, Abderson, SC 29625 | 2015-04-16 |
| 1295162048 | Kimberly Dickerson | Pharmacist | 922 Highway 28 By-pass, Anderson, SC 29625 | 2013-10-10 |
| 1386998458 | Judy E. Festa-hanna | Counselor | 226 Mcgee Road, Anderson, SC 29625 | 2012-10-29 |
| 1902156201 | Britanny Ab Rood | Pharmacist | 109 Hwy 28 Bypass, Anderson, SC 29625 | 2012-09-13 |
| 1689993065 | Carey Glenn | Midwife | 1107 Watkins Rd, Anderson, SC 29625 | 2010-05-24 |
| 1033350616 | Mobility Rehab Products, LLC | Durable Medical Equipment & Medical Supplies | 235 Polaris Street, Anderson, SC 29625 | 2009-03-12 |
| 1437329018 | Moriah Healthcare Services LLC | Clinic/Center | 823 Pearman Dairy Rd, Anderson, SC 29625 | 2008-03-10 |
| Find all providers in zip 29625 | ||||
| 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 |
|---|---|---|---|---|
| 1598173627 | Blue Ridge Oral and Maxillofacial Surgery Pa | Dentist | 209 E Highland Ave, Anderson, SC 29621-4711 | 2014-08-01 |
| 1326173428 | Anderson Oral and Maxillofacial Surgery, Pa | Dentist | 1209 Ella Street, Anderson, SC 29621 | 2007-02-22 |
| 1003978586 | Chris D Kinney | Dentist | 3825 Fairview Dr, Anderson, IN 46013 | 2006-12-14 |
| 1568538098 | Oral and Maxillofacial Surgery of Anderson,llc | Dentist | 1514 North Fant Street, Anderson, SC 29621-4708 | 2006-11-27 |
| 1164492104 | Shad Demar Roundy | Dentist | 1601 Medical Arts Blvd Ste 301, Anderson, IN 46011-3460 | 2006-01-24 |
| 1225011323 | Lewis Tyler Sumner | Dentist | 1209 Ella St, Anderson, SC 29621-4811 | 2005-11-22 |
| 1891172797 | Anderson Oral and Maxillofacial Surgery | Dentist | 1601 Medical Arts Blvd, Suite 3, Anderson, IN 46011-3458 | 2015-04-29 |
| 1457628711 | Chris D. Kinney, D.d.s. P.C. | Dentist | 3825 Fairview Dr, Anderson, IN 46013-4059 | 2011-11-30 |
| 1649316241 | William S. Dunlap Jr. | Dentist | 1514 North Fant Street, Anderson, SC 29621-4708 | 2007-01-30 |
| 1740386242 | Howard H. Mohler Dds Inc | Dentist | 1601 Medical Arts Blvd, Suite 301, Anderson, IN 46011-3458 | 2006-09-15 |
| Find all providers in ANDERSON | ||||
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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.