DR. JENNIE O REARDON (NPI# 1568895357) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568895357 |
| Entity Type | Individual |
| Full Name | DR. JENNIE O REARDON |
| Credential | DMD |
| Practice Address |
9565 Highway 78 Unit 600b Ladson SC 29456-4118 |
| Practice Telephone | 8434124036 |
| Enumeration Date | 2013-08-15 |
| Last Update Date | 2013-09-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
8265 | SC | Dental Providers |
| Street Address |
9565 HIGHWAY 78 UNIT 600B |
| City | LADSON |
| State | SC |
| Zip Code | 29456-4118 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134121015 | Marianne S Geraci | Ophthalmology | 9565 Highway 78, Bldg 100, Ladson, SC 29456-4118 | 2005-08-11 |
| 1386148617 | Southern Coast Specialists, LLC | Anesthesiology | 9565 Highway 78, Bldg 100, Ladson, SC 29456 | 2018-03-21 |
| 1225431455 | Brandon Mychael Ware | Physician Assistant | 9565 Highway 78, Suite 400, Ladson, SC 29456-4118 | 2014-10-02 |
| 1558794396 | Dr. Patricia Nicklas | Dentist | 9565 Highway 78, Unit 600b, Ladson, SC 29456-4118 | 2013-08-15 |
| 1225391915 | Childrens Eye Specialists LLC | Ophthalmology | 9565 Highway 78, Bldg 600, Ladson, SC 29456-4118 | 2012-06-19 |
| 1548534381 | Phelan Giles Piehota | Ophthalmology | 9565 Highway 78, Bldg 200, Ladson, SC 29456-4118 | 2012-02-24 |
| 1316182249 | Amanda W. Lee | Speech-Language Pathologist | 9565 Highway 78, Building 700 Suite 102, Ladson, SC 29456 | 2008-12-05 |
| 1629220611 | Cataract and Laser Center of Charleston | Ophthalmology | 9565 Highway 78, Suite 100, Ladson, SC 29456-4118 | 2008-10-21 |
| 1538323654 | Dr. David W. Bang, P.C. | Optometrist | 9565 Highway 78, Building 900, Ladson, SC 29456-3912 | 2008-07-17 |
| 1710174297 | Dr. David W. Bang, P.C. | Optometrist | 9565 Highway 78, Bldg 900, Ladson, SC 29456-3912 | 2007-09-28 |
| Find all providers in the same location | ||||
| 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 |
| 1467982728 | Heritage Dental LLC | Clinic/Center | 9598 Palmetto Commerce Parkway, Ladson, SC 29456 | 2017-06-19 |
| 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 |
| Find all providers in zip 29456 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174159248 | Ingleside Family Dental, LLC | Dentist | 9403 Highway 78, Suite 201, Ladson, SC 29456 | 2020-03-20 |
| 1558794396 | Dr. Patricia Nicklas | Dentist | 9565 Highway 78, Unit 600b, Ladson, SC 29456-4118 | 2013-08-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518564046 | Leishman Dental | Dentist | 121 N Pine St, Batesburg Leesville, SC 29006-1974 | 2020-10-07 |
| 1265039754 | Ravi Bhupen Patel | Dentist | 1755 Central Park Rd, Unit 1107, Charleston, SC 29412-2846 | 2020-10-07 |
| 1447857289 | Rick & Pamela Dhillon Dmd - Sda LLC | Dentist | 3115a Brushy Creek Rd, Greer, SC 29650-0903 | 2020-10-05 |
| 1598372864 | Dental Professional of South Carolina, P.C. | Dentist | 1417 Folly Rd Ste 402, Charleston, SC 29412-9737 | 2020-09-30 |
| 1043827314 | Dental Professionals of South Carolina, P.C. | Dentist | 1767 Heckle Blvd Ste 102, Rock Hill, SC 29732-1878 | 2020-09-30 |
| 1497361307 | Cane Bay Family Dentistry - Goose Creek LLC | Dentist | 129 Plantation North Blvd, Unit D, Goosecreek, SC 29445-2944 | 2020-09-17 |
| 1851906028 | Carolina Park Family Dentistry LLC | Dentist | 3520 Park Avenue Blvd., Suite 100, Mount Pleasant, SC 29466-2946 | 2020-09-14 |
| 1952915027 | Vdp Okatie LLC | Dentist | 10 William Pope Drive, Suite #2, Okatie, SC 29909 | 2020-09-04 |
| 1881208296 | Amanda Ho Van Garrett | Dentist | 122 S Goose Creek Blvd Ste A, Goose Creek, SC 29445-3136 | 2020-09-02 |
| 1871107409 | Ashley Czechner | Dentist | 11990 Highway 17 Byp Ste 8, Murrells Inlet, SC 29576-9379 | 2020-09-01 |
| 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.