NORTHEAST ORAL & MAXILLOFACIAL (NPI# 1407067473) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407067473 |
| Entity Type | Organization |
| Organization Name | NORTHEAST ORAL & MAXILLOFACIAL |
| Other Organization Name | GARNERS FERRY ORAL & MAXILLOFACIAL SURGERY CENTER |
| Practice Address |
1118 Greenlawn Dr Columbia SC 29209-2606 |
| Practice Telephone | 8036951118 |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2008-08-06 |
| Authorized Official Name | MRS. TRICIA E. LASSETER (INSURANCE COORDINATOR) |
| Authorized Official Telephone | 8036995900 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0106X |
Dentist Specialization: Oral and Maxillofacial Pathology |
Dental Providers |
| Other Name | Type Code |
|---|---|
| GARNERS FERRY ORAL & MAXILLOFACIAL SURGERY CENTER | Other Name - Individual/Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | NORTHEAST ORAL & MAXILLOFACIAL SURGERY PLLC | 775 Park Avenue, Ste 340, Huntington, Ny 11743 |
| Street Address |
1118 GREENLAWN DR |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29209-2606 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225456247 | Ancient Mariner, LLC | Clinic/Center | 1118 Greenlawn Dr, Columbia, SC 29209-2606 | 2014-04-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992293013 | Pertile Group LLC | Family Medicine | 26 Foot Point Rd, Columbia, SC 29209 | 2018-04-24 |
| 1083156061 | Derek Clark | Physical Therapist | 6349 Garners Ferry Rd, Columbia, SC 29209 | 2016-11-08 |
| 1922450345 | Heather Alexander | Social Worker | 6439 Garners-ferry Road, Suite 122, Wjb Dorn Va, Columbia, SC 29209 | 2016-07-09 |
| 1265888325 | Daphne Elaine Allen | Counselor | 1850 Pinview Dr, Columbia, SC 29209 | 2016-05-09 |
| 1659757649 | Marc Edmundson | Pharmacist | 500 Gills Creek Pkwy #810, Columbia, SC 29209 | 2015-08-03 |
| 1477949113 | Winter Years Home Health Care Agency, LLC | Home Health | 1101 1st Street, P, Columbia, SC 29209 | 2015-04-09 |
| 1285045773 | Alireza Adhami | Pharmacist | 7235 Garners Ferry Rd, Columbia, SC 29209 | 2014-05-19 |
| 1790039212 | Immediate Dental Group Columbia | Dentist | 1118 Greenlawn Drive, Columbia, SC 29209 | 2012-11-06 |
| 1275896284 | Tariq Horani | Internal Medicine | 6349 Garners Ferry Road, Int Med -, Columbia, SC 29209 | 2012-06-25 |
| 1902165467 | Medcare Urgent Care Center Garners Ferry, LLC | Clinic/Center | 7418 Garners Ferry Road, Columbia, SC 29209 | 2012-05-03 |
| Find all providers in zip 29209 | ||||
| Taxonomy Code | 1223P0106X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Pathology |
| The specialty of dentistry and discipline of pathology that deals with the nature, identification, and management of diseases affecting the oral and maxillofacial regions. It is a science that investigates the causes, processes, and effects of these diseases. The practice of oral and maxillofacial pathology includes research and diagnosis of diseases using clinical, radiographic, microscopic, biochemical, or other examinations. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700916822 | Northeast Oral & Maxillofacial Surgery Center | Dentist | 9310 Two Notch Rd, Columbia, SC 29223-6416 | 2007-03-07 |
| 1003929449 | James W Andrews | Dentist | 1000 W Nifong Blvd, Bldg 4 Ste 100, Columbia, MO 65203-5661 | 2006-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174656540 | River Falls Oral Surgery | Dentist | 700 Squires Pt, Duncan, SC 29334-8879 | 2007-03-14 |
| 1871606830 | Jonathan M Lafond | Dentist | 455 Old Trolley Rd, Ste E, Summerville, SC 29485-5669 | 2006-08-16 |
| 1982622585 | Derek T Dunlap | Dentist | 700 Squire's Pointe Drive, Suite A, Duncan, SC 29334 | 2006-07-18 |
| 1831156777 | Larry Wayne Cobb | Dentist | 2c Cleveland Ct, Greenville, SC 29607-2414 | 2006-04-26 |
| 1912969502 | Theresa Sullivan Gonzales | Dentist | 173 Ashley Avenue Msc 507, Charleston, SC 29401 | 2006-04-06 |
| 1891774162 | Thomas Herbert Simpson Jr. | Dentist | 372 S Herlong Ave, Rock Hill, SC 29732 | 2006-01-13 |
| 1639593254 | Medical University of South Carolina | Dentist | 173 Ashley Ave, Charleston, SC 29425-8908 | 2014-02-18 |
| 1194026153 | Medical University of Sc | Dentist | 173 Ashley Ave, Charleston, SC 29425-8908 | 2010-11-08 |
| 1396904405 | Christel Maria Haberland | Dentist | 171 Ashley Ave, Charleston, SC 29425-4804 | 2008-06-03 |
| 1518177807 | Orangeburg Oral Surgery & Implant Center | Dentist | 1175 Cook Rd, Ste 135, Orangeburg, SC 29118-8201 | 2007-05-23 |
| Find all providers with the same taxonomy | ||||
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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.