DR. RENATA SERRICCHIO LEITE (NPI# 1629585880) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629585880 |
| Entity Type | Individual |
| Full Name | DR. RENATA SERRICCHIO LEITE |
| Credential | MS, DDS |
| Practice Address |
29 Bee Street Charleston SC 29425-0001 |
| Mailing Address |
Po Box 12595 Charleston SC 29422-2595 |
| Practice Telephone | 8437923908 |
| Enumeration Date | 2018-01-09 |
| Last Update Date | 2018-01-09 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
29 | SC | Dental Providers |
| Street Address |
29 BEE STREET |
| City | CHARLESTON |
| State | SC |
| Zip Code | 29425-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427254242 | Nathan Christopher Seng | Dentist | 29 Bee Street, Charleston, SC 29403 | 2007-06-27 |
| 1073155305 | Alexandra D Ortega-arguello | Dentist | 29 Bee Street, Charleston, SC 29403 | 2019-10-08 |
| 1902303852 | John Ashton Durant | Dentist | 29 Bee Street, Charleston, SC 29424-0001 | 2018-04-08 |
| 1063917128 | William Banks Lee | Student in an Organized Health Care Education/Training Program | 29 Bee Street, Charleston, SC 29403 | 2018-03-29 |
| 1669970034 | Jordan Miles Christensen | Dentist | 29 Bee Street, Charleston, SC 29403 | 2018-01-31 |
| 1720599939 | Shrineel Patel | Dentist | 29 Bee Street, Charleston, SC 29425-0001 | 2017-10-14 |
| 1366961682 | Brittany Leigh Field | Dentist | 29 Bee Street, Charleston, SC 29425-0001 | 2017-09-18 |
| 1104297688 | Guang Li | Dentist | 29 Bee Street, Charleston, SC 29403 | 2015-10-09 |
| 1003190968 | James Randall Marshall | Dentist | 29 Bee Street, Dc 500, Charleston, SC 29425 | 2011-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922607217 | Krishna Bhandari | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 10 Mcclennan Banks Drive, 2190-r, Msc 918, Charleston, SC 29425 | 2020-10-19 |
| 1649892456 | Mary Macrae Lynch | Social Worker | 179 Ashley Avenue, Charleston, SC 29425 | 2020-05-14 |
| 1528600053 | Amanda Watts | Physician Assistant | 135 Rutledge Ave. Msc 561, Charleston, SC 29425 | 2019-10-16 |
| 1851945497 | Kacy Wonder | Dentist | 173 Ashley Avenue Room 453 Msc 507, Charleston, SC 29425 | 2019-08-01 |
| 1477114569 | Justin Robert Silverman | Surgery | 169 Ashley Avenue, Room 202 Muh, Msc 333, Charleston, SC 29425 | 2019-06-28 |
| 1740840024 | Tyler Buckley | Surgery | 169 Ashley Ave, Room 202 Main Hospital, Msc333, Charleston, SC 29425 | 2019-06-18 |
| 1366001760 | Rayphael Sebastian Hardy | Internal Medicine | 169 Ashley Avenue Room 202 Main Hospital Msc333, Charleston, SC 29425 | 2019-06-10 |
| 1437718889 | Samar Medani | Internal Medicine | Division of Nephrology, Medical Univ of South Carolina, 96 Jonathan Lucas Street, Room 822, Msc 629, Charleston, SC 29425 | 2019-06-10 |
| 1427617950 | Emily Suzanne Nyers | Internal Medicine | 169 Ashley Ave., Room 202 Main Hospital, Msc 333, Charleston, SC 29425 | 2019-06-09 |
| 1790343564 | Alan Cowei Peh | Psychiatry & Neurology | 169 Ashley Avenue Rm 202, Main Hospital Msc 333, Charleston, SC 29425 | 2019-06-05 |
| Find all providers in zip 29425 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487184727 | Hillary Nona Wright | Dentist | 1064 Gardner Rd Ste 110, Charleston, SC 29407-5711 | 2017-06-19 |
| 1134472426 | Jeffrey J Laro | Dentist | 2090 Charlie Hall Blvd, Suite 100, Charleston, SC 29414-8200 | 2012-10-24 |
| 1407117385 | Kara Grasso Veeder | Dentist | 173 Ashley Ave Ste 119, Charleston, SC 29425-8908 | 2012-06-06 |
| 1013288786 | Periodontal Associates LLC | Dentist | 33 Gamecock Ave Ste A, Charleston, SC 29407-3397 | 2012-01-26 |
| 1508089301 | Christine Marie Cole | Dentist | 520 Stone Creek Dr, Charleston, SC 29414-5051 | 2007-04-10 |
| 1457476566 | Christopher Jude Caputo | Dentist | 33a Gamecock Ave, Periodontal Associates, Pa, Charleston, SC 29407-3369 | 2007-03-20 |
| 1669530994 | Joe William Krayer | Dentist | 173 Ashley Bsb 346, Dental Faculty Prac College of Dental Medicine Musc, Charleston, SC 29425 | 2006-12-06 |
| 1740646769 | Trident Dental Specialty Partners | Dentist | 6335 Dorchester Rd, Charleston, SC 29418-5103 | 2016-01-06 |
| 1114332921 | Zachary P Evans | Dentist | 1064 Gardner Rd, Suite #110, Charleston, SC 29407-5768 | 2014-07-01 |
| 1609207554 | Mark F. Yampolsky, Dds, Ms Dba Carolina Periodontics | Dentist | 1064 Gardner Rd, Suite #110, Charleston, SC 29407-5768 | 2013-12-03 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 29425 |
Please comment or provide details below to improve the information on DR. RENATA SERRICCHIO LEITE.
| 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.