HERITAGE DENTAL LLC (NPI# 1467982728) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467982728 |
| Entity Type | Organization |
| Organization Name | HERITAGE DENTAL LLC |
| Other Organization Name | HERITAGE DENTAL LLC |
| Practice Address |
9598 Palmetto Commerce Parkway Ladson SC 29456 |
| Practice Telephone | 8605735681 |
| Enumeration Date | 2017-06-19 |
| Last Update Date | 2018-06-20 |
| Authorized Official Name | DR. ROBERT ALAN BREAULT (PRESIDENT) |
| Authorized Official Telephone | 8605735681 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
8323 | SC | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Heritage Dental LLC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154574846 | Heritage Dental LLC | Dentist | 1400 10th Ave Sw, Waverly, IA 50677-3752 | 2008-10-28 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | HERITAGE DENTAL LLC | 1400 10th Ave Sw, P.o. Box 854, Waverly, IA 50677 |
| Street Address |
9598 PALMETTO COMMERCE PARKWAY |
| City | LADSON |
| State | SC |
| Zip Code | 29456 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174159248 | Ingleside Family Dental, LLC | Dentist | 9403 Highway 78, Suite 201, Ladson, SC 29456 | 2020-03-20 |
| 1598231359 | Destiny Jenay Adkins | Specialist/Technologist | 9525 Highway 78 Apartment 400-207, Ladson, SC 29456 | 2018-10-19 |
| 1477049484 | Adebambo Adesanya | Driver | 1008 Turtle Dove Ln, Ladson, SC 29456 | 2018-07-03 |
| 1184117327 | Lauren Elizabeth Bradley | Speech-Language Pathologist | 9565 Hwy 78, Bldg. 700, Ste. 102, Ladson, SC 29456 | 2018-06-12 |
| 1205348067 | Samantha Marie Grimes | Speech-Language Pathologist | 9565 Highway 78 Bldg 102, Ladson, SC 29456 | 2017-11-01 |
| 1699295915 | Sara Paige Gagnier | Occupational Therapist | 9565 Hwy 78 Bldg 700 Ste 102, Ladson, SC 29456 | 2017-06-27 |
| 1013384239 | Zachary Jordan | Pharmacist | 3685 Ladson Rd., Ladson, SC 29456 | 2015-08-24 |
| 1831534676 | Tracie Jo Horton | Registered Nurse | 3321 Ladson Rd., Ladson, SC 29456 | 2013-05-07 |
| 1972859684 | Nicole Marie Hall | Physical Therapist | 4340 Ladson Rd Ste B, Ladson, SC 29456 | 2012-07-31 |
| 1366712242 | Mary Ashton Pratt | Physical Therapist | 3481 Ladson Road, Ladson, SC 29456 | 2012-01-09 |
| Find all providers in zip 29456 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790386613 | Grinville Dentistry LLC | Clinic/Center | 114 Laurens Rd Ste A, Greenville, SC 29607-1826 | 2020-11-06 |
| 1699380923 | Beaufort Center for Dentistry LLC | Clinic/Center | 1264 Ribaut Rd Ste 401, Beaufort, SC 29902-6129 | 2020-09-14 |
| 1154934354 | Spectrum Integrative Dentistry | Clinic/Center | 2131 Woodruff Rd Ste 1100, Greenville, SC 29607-5934 | 2020-08-26 |
| 1992316053 | Childrens Dentistry of Greenville | Clinic/Center | 410 Pelham Rd Ste A, Greenville, SC 29615-3502 | 2020-08-12 |
| 1457978207 | Dash Dental LLC | Clinic/Center | 310 Business Pkwy Ste D, Greer, SC 29651-7118 | 2020-06-28 |
| 1851916332 | Palmetto Advanced Dentistry | Clinic/Center | 2021 Bridgemill Dr Ste 100, Indian Land, SC 29707-9211 | 2020-06-10 |
| 1326669714 | River Landing Dentistry At Nexton LLC | Clinic/Center | 200 Brighton Park Blvd Ste A, Summerville, SC 29486-3000 | 2020-04-27 |
| 1730715293 | Fort Mill Dobys Bridge Dental LLC | Clinic/Center | 1500 Fort Mill Pkwy #108, Fort Mill, SC 29715 | 2020-03-17 |
| 1215570643 | Pearl Dental Studio | Clinic/Center | 117 Batesville Rd Ste 202, Simpsonville, SC 29681-4815 | 2019-10-17 |
| 1497303770 | Holy City Dentistry LLC | Clinic/Center | 862 Folly Rd Ste 110, Charleston, SC 29412-3452 | 2019-08-29 |
| 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.