COASTAL KIDS DENTAL (NPI# 1659693695) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659693695 |
| Entity Type | Organization |
| Organization Name | COASTAL KIDS DENTAL |
| Practice Address |
1000 Tanner Ford Blvd Suite 370 Hanahan SC 29410-4707 |
| Mailing Address |
216 E Main St Moncks Corner SC 29461-3709 |
| Practice Telephone | 8438185437 |
| Practice Fax Number | 8437251594 |
| Mailing Telephone | 8438185437 |
| Mailing Fax Number | 8437251594 |
| Enumeration Date | 2010-02-18 |
| Last Update Date | 2010-02-18 |
| Authorized Official Name | MR. JACOB G DRIGGERS (DIRECTOR OF OPERATIONS) |
| Authorized Official Telephone | 8438184537 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
SC3889 | SC | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801036637 | Coastal Kids Dental | Dentist | 1931 Strathmoor Blvd, Louisville, KY 40205-2525 | 2009-03-06 |
| 1093117558 | Coastal Kids Dental | Dentist | 808 Wappoo Rd, Charleston, SC 29407-5865 | 2014-09-16 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Coastal Kids Dental PA | 808 Wappoo Road, Charleston, SC 29407 |
| Street Address |
1000 TANNER FORD BLVD SUITE 370 |
| City | HANAHAN |
| State | SC |
| Zip Code | 29410-4707 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184789281 | Isabel Ghowanlu Driggers | Dentist | 1000 Tanner Ford Blvd, Suite 370, Hanahan, SC 29410-4707 | 2006-12-27 |
| 1720553209 | Sarah Crawford | Pharmacist | 1000 Tanner Ford Blvd, Hanahan, SC 29410-4707 | 2018-10-10 |
| 1598154999 | Coastal Kids Dental & Braces | Dentist | 1000 Tanner Ford Blvd, Ste 370, Hanahan, SC 29410-4707 | 2015-01-22 |
| 1538571005 | Elissa Lauren Teasdale | Dentist | 1000 Tanner Ford Blvd, Hanahan, SC 29410-4707 | 2014-06-02 |
| 1427330695 | Joseph Brian Clark | Pharmacist | 1000 Tanner Ford Blvd, Hanahan, SC 29410 | 2011-09-14 |
| 1386924843 | Seth Ian Zeigler | Pharmacist | 1000 Tanner Ford Blvd, Hanahan, SC 29410-4707 | 2011-08-27 |
| 1699921726 | Bi-lo, LLC. | Durable Medical Equipment & Medical Supplies | 1000 Tanner Ford Blvd, Hanahan, SC 29410 | 2008-08-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174148415 | Peachy Speech LLC | Speech-Language Pathologist | 1004 Holcombe Rd, Hanahan, SC 29410 | 2020-06-12 |
| 1922510783 | Tedc | Pharmacy | 1298 Yeamans Hall Rd, Hanahan, SC 29410 | 2017-11-01 |
| 1962811471 | Tammy Elizabeth Hiott | Nurse Practitioner | 1800 Eagle Landing Boulevard, Agape Physicians Care At Heartland of Hanahan, Hanahan, SC 29410 | 2014-08-08 |
| 1568718351 | John Bradley Palles | Dentist | 1224 Yeamans Hall Road, Hanahan, SC 29410 | 2012-07-30 |
| 1316292816 | Blaine Allen Burris | Specialist/Technologist | 7344 Suncatcher Dr, Hanahan, SC 29410 | 2012-07-20 |
| 1437221959 | Kjersti Damsker | Dentist | 1000 Tanner Ford Blvd., Hanahan, SC 29410 | 2006-11-14 |
| 1619063443 | Laurie Johnson Tackett | Occupational Therapist | 7313 Horned Grebe Ct, Hanahan, SC 29410 | 2006-10-05 |
| 1205938040 | Nancey Trevanian Tsai | Physical Medicine & Rehabilitation | 18 N Basilica Ave, Hanahan, SC 29410 | 2006-09-02 |
| 1194791087 | Morgan A Lowry | Internal Medicine | 7323 Water Thrush Ct, Hanahan, SC 29410 | 2006-02-28 |
| 1972579456 | Stephen C Chadwick | Dentist | 1005 Tanner Ford Blvd, Suite 102, Hanahan, SC 29410 | 2006-02-24 |
| Find all providers in zip 29410 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811598493 | Pleasant Mill Pediatric Dentistry | Dentist | 1690 Highway 160 W Ste A, Fort Mill, SC 29708-8024 | 2020-11-02 |
| 1124635495 | Destination Dental of Duncan LLC | Dentist | 155 Deacon Tiller Ct, Duncan, SC 29334-8880 | 2020-09-30 |
| 1487267365 | Cp Dentistry, LLC | Dentist | 9919 Dorchester Road, Summerville, SC 29485 | 2020-08-28 |
| 1811519507 | Stephanie Silva Dmd, LLC | Dentist | 133 Allen Court, North Augusta, SC 29860 | 2020-05-15 |
| 1235776568 | Tribe Dental LLC | Dentist | 11 Magnolia Cove Dr, Simpsonville, SC 29680 | 2019-12-05 |
| 1457994196 | Sfd Mt. Pleasant LLC | Dentist | 3102 N Highway 17, Mount Pleasant, SC 29466-6925 | 2019-10-25 |
| 1073162053 | Southern Charm Pediatric Dentistry | Dentist | 2021 Bridgemill Rd., Suite 108, Indian Land, SC 29707-2817 | 2019-09-11 |
| 1649825969 | Oak Landing Pediatric Dentistry, LLC | Dentist | 2001 2nd Ave Ste 102, Summerville, SC 29486-7887 | 2019-08-04 |
| 1851858013 | The Tot Spot of South Carolina | Dentist | 1334 S. Hwy 14, Simpsonville, SC 29681 | 2019-02-25 |
| 1588130942 | Dentistry for Children of South Carolina PC | Dentist | 1701 Beaucastel Rd Ste A, Mount Pleasant, SC 29464-3685 | 2018-10-23 |
| 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.