BRENT R. HUMPHREY (NPI# 1831378686) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831378686 |
| Entity Type | Individual |
| Full Name | BRENT R. HUMPHREY |
| Credential | D.M.D. |
| Practice Address |
103 Spring Hall Dr Goose Creek SC 29445-5336 |
| Practice Telephone | 8437972000 |
| Practice Fax Number | 8437978826 |
| Mailing Telephone | 8437972000 |
| Mailing Fax Number | 8437978826 |
| Enumeration Date | 2007-10-29 |
| Last Update Date | 2007-10-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
2872 | SC | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | Z2872-9 | 05 |
| Street Address |
103 SPRING HALL DR |
| City | GOOSE CREEK |
| State | SC |
| Zip Code | 29445-5336 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790309953 | Auriel Mcconnell | Home Health | 616 One Mans Court, Mount Pleasant, SC 29445 | 2020-06-03 |
| 1215594023 | Tanova Cornise Robinson | Counselor | 96 Wisteria Road, Goose Creek, SC 29445 | 2019-05-28 |
| 1417421777 | Debra Liana Kerness | Social Worker | 100-a Central Avenue, Suite 203, Goose Creek, SC 29445 | 2019-01-18 |
| 1043663503 | Aimee Nehiley | Dentist | 615 Saint James Ave, Goose Creek, SC 29445 | 2016-07-20 |
| 1881057032 | Eddie Emanuel Nance | Family Medicine | 110 Naval Nuclear Power Training Command Cir, Goose Creek, SC 29445 | 2016-04-04 |
| 1295195188 | Dental Professionals of South Carolina, PC | Dentist | 615 St. James Ave, Goose Creek, SC 29445 | 2016-03-04 |
| 1144603622 | Laryssa Smith | Pharmacist | 215 St. James Ave, Goose Creek, SC 29445 | 2015-07-02 |
| 1730439126 | O'stacia Williamson | Pharmacist | 1316 Redbank Rd, 9, Goose Creek, SC 29445 | 2012-09-13 |
| 1164771275 | Mary Ashley Watts | Pharmacist | 431 B St James Ave Suite I, Goose Creek, SC 29445 | 2012-09-05 |
| 1598048860 | Brianne Michele Terry | Pharmacist | 142 East Saint James Ave, Goose Creek, SC 29445 | 2011-09-23 |
| Find all providers in zip 29445 | ||||
| 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 |
|---|---|---|---|---|
| 1316950843 | Brent R. Humphrey Dmd, P.a. | Dentist | 103 Springhall Dr, Goose Creek, SC 29445-5336 | 2006-08-14 |
| 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 | ||||
| City | GOOSE CREEK |
| Zip Code | 29445 |
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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.