KENNETH STEVEN BARRACK (NPI# 1295999100) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295999100 |
| Entity Type | Individual |
| Full Name | KENNETH STEVEN BARRACK |
| Credential | DDS |
| Practice Address |
682 Johnnie Dodds Blvd Ste 102 Mt Pleasant SC 29464-3028 |
| Practice Telephone | 8438499044 |
| Mailing Telephone | 8438499044 |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2011-08-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0700X |
Dentist Specialization: Prosthodontics |
3150 | SC | Dental Providers |
| Street Address |
682 JOHNNIE DODDS BLVD STE 102 |
| City | MT PLEASANT |
| State | SC |
| Zip Code | 29464-3028 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811548241 | Bradley Paul Anuszkiewicz | Chiropractor | 1501 Johnnie Dodds Blvd, Suite C, Mount Pleasant, SC 29464 | 2019-09-26 |
| 1447808696 | Laura Mariah Crouse | Speech-Language Pathologist | Coastal Therapy Services, 1127 Queensborough Blvd, Mt Pleasant, SC 29464 | 2019-08-30 |
| 1912461807 | Independent Optical | Optometrist | 1710 Shoremead Rd, Suite 420, Mount Pleasant, SC 29464 | 2019-01-25 |
| 1417446204 | Michael Adam Sugarman | Clinical Neuropsychologist | 1459 Stuart Engals Blvd Ste 204a, Mt Pleasant, SC 29464 | 2018-05-07 |
| 1578064192 | Ancillary Specialists LLC | Durable Medical Equipment & Medical Supplies | 636 Long Point Road, Unit G, #19, Mount Pleasant, SC 29464 | 2018-02-28 |
| 1346769015 | Christin Solomon Zerega | Counselor | Lowcountry Psychiatry Group, 913 Bowman Rd, #4, Mount Pleasant, SC 29464 | 2017-09-14 |
| 1336660315 | Charleston Neuropsychology LLC | Psychologist | 1459 Stuart Engals Blvd., Suite 204a, Mount Pleasant, SC 29464 | 2017-06-29 |
| 1790219970 | Adam Hudepohl | Family Medicine | 1400 Ben Sawyer Blvd, Mt Pleasant, SC 29464 | 2017-04-14 |
| 1386181204 | Alicia Taylor | Speech-Language Pathologist | 381 Stonewall Ct Apt 6207, Mount Pleasant, SC 29464 | 2017-01-30 |
| 1285181941 | Tara Lynn Mast | Physical Therapist | 1400 Caliper Oak Circle, Apt 316, Mount Pleasant, SC 29464 | 2016-09-09 |
| Find all providers in zip 29464 | ||||
| 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 |
|---|---|---|---|---|
| 1598929408 | Mayur Mahendra Patel | Dentist | 682 Johnnie Dodds Blvd, Suite 102, Mt Pleasant, SC 29464-3028 | 2008-07-10 |
| 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 |
| 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 |
| 1457554974 | Stephen Patrick Schoen | Dentist | 10 Enterprise Boulevard, Suite 103, Greenville, SC 29615 | 2007-06-11 |
| 1932329182 | John A Crumpton Dmd Pa | Dentist | 36 Roper Corners Circle, Greenville, SC 29615 | 2007-04-30 |
| Find all providers with the same taxonomy | ||||
| City | MT PLEASANT |
| Zip Code | 29464 |
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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.