UPSTATE PROSTHODONTICS, L.L.C. (NPI# 1841365095) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841365095 |
| Entity Type | Organization |
| Organization Name | UPSTATE PROSTHODONTICS, L.L.C. |
| Practice Address |
321 Mills Ave Greenville SC 29605-4021 |
| Practice Telephone | 8642323882 |
| Practice Fax Number | 8642407494 |
| Mailing Telephone | 8642323882 |
| Mailing Fax Number | 8642407494 |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. DONALD LEE RIDGELL (DOCTOR) |
| Authorized Official Telephone | 8642323882 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0700X |
Dentist Specialization: Prosthodontics |
0361 | SC | Dental Providers |
| Street Address |
321 MILLS AVE |
| City | GREENVILLE |
| State | SC |
| Zip Code | 29605-4021 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184975484 | Donald L Ridgell | Dentist | 321 Mills Ave, Greenville, SC 29605-4021 | 2012-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205306099 | Prisma Health University Medical Group | Family Medicine | 110 Osage Drive, Greenville, SC 29605 | 2018-12-05 |
| 1306325626 | Lauren Foster Fiscus | Occupational Therapist | 1900 Augusta Street, Suite 2500, Greenville, SC 29605 | 2018-08-08 |
| 1063914372 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 1720 Augusta St, Greenville, SC 29605 | 2018-03-02 |
| 1144748385 | Johanna Ruth Henry | Speech-Language Pathologist | 1900 Augusta St., Suite 2500, Greenville, SC 29605 | 2017-09-08 |
| 1477083483 | Alexis Dean Pedigo | Speech-Language Pathologist | 1900 Augusta St, Suite 2500, Greenville, SC 29605 | 2017-06-13 |
| 1134658420 | Trace Christopher Deighan | Obstetrics & Gynecology | 890 West Faris Road, Suite 470, Greenville, SC 29605 | 2017-06-08 |
| 1023569837 | Blessed With Goodness, LLC | In Home Supportive Care | 716 E. Fairfield Road, Unit 120 (mailbox # 14), Greenville, SC 29605 | 2016-10-17 |
| 1972050953 | Suha Umina | Pharmacist | 975 W. Faris Road, Greenville, SC 29605 | 2016-09-07 |
| 1124470976 | Meredith Laine Cavagrotti | Specialist/Technologist | 700 Grove Rd, Greenville, SC 29605 | 2016-07-05 |
| 1205286895 | Med-trans Corporation | Ambulance | 552 Perimeter Rd, Greenville, SC 29605 | 2016-06-15 |
| Find all providers in zip 29605 | ||||
| Taxonomy Code | 1223P0700X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Prosthodontics |
| That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558799916 | Mahmoud Serag | Dentist | 2712 W Arlington Blvd Apt 206, Greenville, NC 27834-4115 | 2013-10-23 |
| 1639437163 | Keith A Mays | Dentist | Lakeside Annex 7, Ms 701, East Carolina University School of Dentistry, Greenville, NC 27834 | 2012-05-03 |
| 1457554974 | Stephen Patrick Schoen | Dentist | 10 Enterprise Boulevard, Suite 103, Greenville, SC 29615 | 2007-06-11 |
| 1932329182 | John A Crumpton Dmd Pa | Dentist | 36 Roper Corners Circle, Greenville, SC 29615 | 2007-04-30 |
| 1104344241 | Moamen E Sheba | Dentist | 1851 Macgregor Downs Rd, Greenville, NC 27834-5925 | 2017-09-08 |
| 1184975484 | Donald L Ridgell | Dentist | 321 Mills Ave, Greenville, SC 29605-4021 | 2012-09-26 |
| 1215180716 | John Anthony Crumpton Sr. | Dentist | 36 Roper Corners Circle, Greenville, SC 29615 | 2008-10-28 |
| 1548270747 | Michael James Smith | Dentist | 41 Park Creek Dr, Greenville, SC 29605-4270 | 2006-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649818048 | Safa Tahmasebi | Dentist | 481 Munn Rd Ste 100, Fort Mill, SC 29715-0014 | 2019-12-16 |
| 1336657386 | Candice Marie Vinson | Dentist | 1149 Oakland Market Rd, Mount Pleasant, SC 29466-8220 | 2018-01-11 |
| 1316459753 | David W Richardson | Dentist | 765 St. Andrews Blvd., Charleston, SC 29407 | 2017-10-25 |
| 1831580620 | Bryan A Lara | Dentist | 110 Auston Woods Cir, Apt U, Easley, SC 29640-4301 | 2015-02-15 |
| 1497146906 | Palmetto Prosthodontics, LLC | Dentist | 145 Woodruff Place Cir, Simpsonville, SC 29681-3672 | 2015-02-05 |
| 1255631214 | Steven Gordon Lewis | Dentist | 481 Munn Rd, Suite 100, Fort Mill, SC 29715-8408 | 2010-10-25 |
| 1598929408 | Mayur Mahendra Patel | Dentist | 682 Johnnie Dodds Blvd, Suite 102, Mt Pleasant, SC 29464-3028 | 2008-07-10 |
| 1295999100 | Kenneth Steven Barrack | Dentist | 682 Johnnie Dodds Blvd Ste 102, Mt Pleasant, SC 29464-3028 | 2008-07-10 |
| 1487812327 | Virgil Vacarean | Dentist | 25 Clark Summit Dr Ste 100, Bluffton, SC 29910-4999 | 2008-05-28 |
| 1003086224 | Adam M Clark | Dentist | 1416 Ashley River Rd, Atlantic Aesthetics, Charleston, SC 29407-5306 | 2008-03-04 |
| Find all providers with the same taxonomy | ||||
| City | GREENVILLE |
| Zip Code | 29605 |
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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.