CAROLINA PERIODONTICS & DENTAL IMPLANTS (NPI# 1649725102) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649725102 |
| Entity Type | Organization |
| Organization Name | CAROLINA PERIODONTICS & DENTAL IMPLANTS |
| Practice Address |
112 W Broad St Unit 405 Greenville SC 29601-2688 |
| Practice Telephone | 4802890507 |
| Enumeration Date | 2016-08-24 |
| Last Update Date | 2016-08-24 |
| Authorized Official Name | DR. SHAWNA BAXTER (PERIODONTIST/OWNER) |
| Authorized Official Telephone | 4802890507 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
8638 | SC | Dental Providers |
| Street Address |
112 W BROAD ST UNIT 405 |
| City | GREENVILLE |
| State | SC |
| Zip Code | 29601-2688 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700305620 | True Sleep Diagnostics | Clinic/Center | 220 North Main St Ste 500, Pmb 104, Greenville, SC 29601 | 2017-09-12 |
| 1245786813 | Yvette Ombougno | Registered Nurse | 200 University Ridge, Greenville, SC 29601 | 2016-09-01 |
| 1477921823 | Laura Gore Siefert | Registered Nurse | 1 Saint Francis Drive, Greenville, SC 29601 | 2015-09-02 |
| 1821493826 | Sarah Fuller | Counselor | 602 Pettigru St, Greenville, SC 29601 | 2014-11-03 |
| 1689088932 | Chenille Taylor | Nurse Practitioner | 201 N. Main Street, Greenville, SC 29601 | 2014-06-15 |
| 1861827842 | Caritas Counseling Services LLC | Community/Behavioral Health | 111 Hampton Avenue, St Mary's Catholic Church, Greenville, SC 29601 | 2013-09-09 |
| 1568790335 | Lynn A. Victory | Counselor | 710 Pettigru Street, The Cottage, Greenville, SC 29601 | 2009-12-06 |
| 1386971448 | Lisa Speach | Nurse Practitioner | 3 St. Francis Drive, Suite 300, Greenville, SC 29601 | 2009-11-11 |
| 1851528418 | Adam Shawn Riffle | Specialist/Technologist | 175 Patewood Drive, Greenville, SC 29601 | 2009-06-22 |
| 1114178332 | Margaret W. Lee | Psychologist | 412 Pettigru St., Suite C, Greenville, SC 29601 | 2008-10-07 |
| Find all providers in zip 29601 | ||||
| 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 |
|---|---|---|---|---|
| 1568084408 | Diane Jenkins Periodontics of Congaree, LLC | Dentist | 600 Congaree Rd, Greenville, SC 29607-3518 | 2020-05-14 |
| 1699844522 | Patrick L Johnson | Dentist | 108 Oakmont Dr, Greenville, NC 27858-5936 | 2006-11-07 |
| 1306929344 | Periodontics of Greenville | Dentist | 1 Charis Dr, Greenville, SC 29615-6615 | 2006-10-23 |
| 1194823633 | Janet Roberts Edwards | Dentist | 517 West Butler Road, Greenville, SC 29607 | 2006-09-20 |
| 1891703419 | Lisa S Ravenel | Dentist | 1130 E Butler Rd, Greenville, SC 29607-5908 | 2006-08-03 |
| 1013569771 | Ravenel Periodontics, Pa | Dentist | 1130 E Butler Rd, Greenville, SC 29607-5908 | 2019-07-12 |
| 1588105829 | Periodontics of Greenville | Dentist | 1130 E Butler Rd, Greenville, SC 29607-5908 | 2017-03-20 |
| 1598178030 | Alex Gillone | Dentist | 1851 Macgregor Downs Rd, Greenville, NC 27834-5925 | 2014-06-03 |
| 1811309321 | Acela Alejandra Martinez Luna | Dentist | 1851 Macgregor Downs Rd, Greenville, NC 27834-5925 | 2014-06-02 |
| 1205177797 | Maged Abdelaal | Dentist | 1851 Macgregor Downs Rd, Greenville, NC 27834-5925 | 2013-03-07 |
| Find all providers in GREENVILLE | ||||
| City | GREENVILLE |
| Zip Code | 29601 |
Please comment or provide details below to improve the information on CAROLINA PERIODONTICS & DENTAL IMPLANTS.
| 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.