EARL B HARTZOG DMD PA (NPI# 1619341138) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619341138 |
| Entity Type | Organization |
| Organization Name | EARL B HARTZOG DMD PA |
| Other Organization Name | BAMBERG ORTHO |
| Practice Address |
474 North St Bamberg SC 29003-1318 |
| Practice Telephone | 8032455545 |
| Practice Fax Number | 8032455534 |
| Mailing Telephone | 8032455545 |
| Mailing Fax Number | 8032455534 |
| Enumeration Date | 2015-11-20 |
| Last Update Date | 2015-11-20 |
| Authorized Official Name | DR. EARL BARRETT HARTZOG (DENTIST) |
| Authorized Official Telephone | 8435601543 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Bamberg Ortho | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548792617 | Earl B Hartzog Dmd Pa | Dentist | 735 Harry C Raysor Dr, St Matthews, SC 29135-8403 | 2017-03-29 |
| 1427502160 | Earl B Hartzog Dmd Pa | Dentist | 649 West Carolina Ave, Varnville, SC 29944 | 2016-08-11 |
| 1689001034 | Earl B Hartzog Dmd Pa | Dentist | 123 Catherine Avenue North, Estill, SC 29918 | 2013-10-01 |
| 1588047724 | Earl B Hartzog Dmd Pa | Dentist | 5576 Carolina Hwy, Denmark, SC 29042-2238 | 2015-07-07 |
| 1497137160 | Earl B Hartzog Dmd Pa | Dentist | 1380 Park St, Orangeburg, SC 29115-4880 | 2015-06-18 |
| 1114202736 | Earl B Hartzog Dmd Pa | Dentist | 474 North St, Bamberg, SC 29003-1318 | 2011-10-14 |
| 1093047896 | Earl B Hartzog Dmd Pa | Dentist | 174 Beech Ave, Denmark, SC 29042 | 2010-02-03 |
| Street Address |
474 NORTH ST |
| City | BAMBERG |
| State | SC |
| Zip Code | 29003-1318 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487608568 | Ernest Gary Jeffords Dmd Pa | Dentist | 474 North St, Bamberg, SC 29003-1318 | 2006-05-21 |
| 1609217637 | Shelly Catlett | Dentist | 474 North St, Bamberg, SC 29003-1318 | 2013-07-06 |
| 1548501018 | Lauren Forster Callison | Dentist | 474 North St, Bamberg, SC 29003-1318 | 2013-03-08 |
| 1114202736 | Earl B Hartzog Dmd Pa | Dentist | 474 North St, Bamberg, SC 29003-1318 | 2011-10-14 |
| 1306986369 | Ernest Gary Jeffords | Dentist | 474 North St, Bamberg, SC 29003-1318 | 2007-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245527530 | James B. Jeffries | Pharmacist | 3518 Main Highway, Bamberg, SC 29003 | 2011-07-07 |
| 1730260118 | State of South Carolina | Public Health or Welfare | 370 Log Branch Road, Bamberg, SC 29003 | 2006-10-18 |
| 1265907224 | Sheryl Edgemon Gardner | Registered Nurse | 370 Log Branch Road, Bamberg, SC 29003 | 2018-10-05 |
| 1336566157 | Paula Boland | Public Health or Welfare | 370 Log Branch Rd, Bamberg, SC 29003 | 2014-03-19 |
| 1427117175 | Shannon T Stokes | Nurse Practitioner | 526 North St, Bamberg, SC 29003 | 2006-12-08 |
| 1679937106 | Tonie Anthony Holman Sr. | Non-emergency Medical Transport (VAN) | 142 Mcmillan St, Bamberg, SC 29003-1039 | 2016-04-11 |
| 1073560645 | Nra Bamberg South Carolina LLC | Clinic/Center | 2046 Main Hwy, Bamberg, SC 29003-1082 | 2006-05-28 |
| 1699796094 | Alton James Beaubeouf Jr. | Chiropractor | 3288 Railroad Ave, Bamberg, SC 29003-1084 | 2006-07-21 |
| 1588943021 | Edisto Regional Health Services Inc. | Clinic/Center | 185 Mcgee St, Bamberg, SC 29003-1154 | 2011-08-16 |
| 1306378310 | Low Country Health Care System | Clinic/Center | 185 Mcgee St, Bamberg, SC 29003-1154 | 2017-03-29 |
| Find all providers in zip 29003 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194332619 | Candid South Carolina, P.C. | Dentist | 136-4 Forum Drive #a20, Columbia, SC 29229 | 2020-09-29 |
| 1518570902 | Foster Orthodontics, Pa | Dentist | 100 Hamlet Cir, Goose Creek, SC 29445-7111 | 2020-08-26 |
| 1740893122 | Foster Orthodontics, Pa | Dentist | 625 Skylark Dr, Charleston, SC 29407-5782 | 2020-08-26 |
| 1629602065 | Keith William Street | Dentist | 1460 John B White Sr Blvd Ste 1-5, Spartanburg, SC 29306-3996 | 2020-02-25 |
| 1225678931 | Rekha Wadhwa | Dentist | 100 Woodruff Place Cir, Simpsonville, SC 29681-3672 | 2020-01-10 |
| 1952965345 | Align America Sc, LLC | Dentist | 259 Textile Way Ste 103, Fort Mill, SC 29715-4550 | 2019-05-01 |
| 1952865289 | Orthodontic Specialists of Carolina, PC | Dentist | 611 Haywood Road, Greenville, SC 29607 | 2019-01-31 |
| 1699267021 | Trevan Samp | Dentist | 22 Westedge St Ste 106b, Charleston, SC 29403-6983 | 2018-06-01 |
| 1548759244 | Smile Doctors of South Carolina, P.C. | Dentist | 105 Ben Casey Dr Ste 109, Fort Mill, SC 29708-8557 | 2018-05-08 |
| 1386158541 | Katherine Dean Solomon | Dentist | 102 Buckwalter Pkwy Ste 3j, Bluffton, SC 29910-4130 | 2017-11-27 |
| 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.