SOUTHEAST ENDODONTICS, PC (NPI# 1902019722) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902019722 |
| Entity Type | Organization |
| Organization Name | SOUTHEAST ENDODONTICS, PC |
| Practice Address |
10 Farmfield Ave Charleston SC 29407-7756 |
| Mailing Address |
10 E Farmfield Avenue Charleston SC 29407 |
| Practice Telephone | 8437660112 |
| Practice Fax Number | 8437660884 |
| Mailing Telephone | 8437660112 |
| Mailing Fax Number | 8437660884 |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. WALTER R. LONG (OWNER) |
| Authorized Official Telephone | 8437660112 |
| Authorized Official Credential | D.M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
3707 | SC | Dental Providers |
| Street Address |
10 FARMFIELD AVE |
| City | CHARLESTON |
| State | SC |
| Zip Code | 29407-7756 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770546624 | Carium Joseph | Obstetrics & Gynecology | 10 Farmfield Ave, Charleston, SC 29407-7756 | 2006-04-11 |
| 1104048289 | Kassis Long Family Dentistry | Dentist | 10 Farmfield Ave, Suite D, Charleston, SC 29407-7756 | 2007-05-02 |
| 1558583617 | Julie Kassis Long | Dentist | 10 Farmfield Ave, Suite D, Charleston, SC 29407-7756 | 2007-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437763661 | Charleston Jaw Surgery | Oral & Maxillofacial Surgery | 846 St. Andrews Blvd., Charleston, SC 29407 | 2020-09-04 |
| 1780225128 | New Endeavors Counseling | Social Worker | 1 Carriage Lane Building E Suite 202, Charleston, SC 29407 | 2019-10-07 |
| 1770063158 | Katelyn Campbell | Psychologist | 1 Carriage Ln Ste 102, Charleston, SC 29407 | 2018-08-15 |
| 1164929956 | Anisha Gulati Md LLC | Psychiatry & Neurology | 925 Wappoo Rd., Suite F, Charleston, SC 29407 | 2018-04-09 |
| 1316459753 | David W Richardson | Dentist | 765 St. Andrews Blvd., Charleston, SC 29407 | 2017-10-25 |
| 1457874174 | Meca Mentality LLC | Chiropractor | 1106 St Andrews Blvd Suite A, Charleston, SC 29407 | 2017-07-25 |
| 1639609373 | Carolina Behavioral Specialists, LLC | Behavioral Analyst | 1529 Sam Rittenberg Blvd, Unit 1-b, Charleston, SC 29407 | 2017-06-15 |
| 1467991901 | Bernice Ladson | Registered Nurse | 75o Magnolia Road, Charleston, SC 29407 | 2017-02-16 |
| 1376991257 | Virginia Leigh Thomason | Counselor | 29 Leinbach Dr, Suite D2, Charleston, SC 29407 | 2016-06-01 |
| 1609221001 | Elinor Lee Smith | Counselor | 571 Savannah Hwy, Charleston, SC 29407 | 2016-05-04 |
| Find all providers in zip 29407 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164710562 | Ernest Stephen Fragale | Dentist | 405 Capitol St Ste 914, Charleston, WV 25301-1744 | 2011-07-19 |
| 1992018899 | Kool Smiles Sc-2, PC | Dentist | 4400 Dorchester Rd Ste 108, Charleston, SC 29405-6863 | 2010-07-20 |
| 1295975977 | Jason H. Cohen, Dmd, LLC | Dentist | 198 Rutledge Ave Ste 3, Charleston, SC 29403-5834 | 2009-02-20 |
| 1669692349 | Walter R. Long | Dentist | 10 Farmfield Ave Ste E, Charleston, SC 29407-7756 | 2007-04-26 |
| 1538386313 | Marc Levitan | Dentist | 173 Ashley Ave Rm 440 Bsb, Musc - Endodontics, Charleston, SC 29425-8908 | 2007-04-20 |
| 1548399793 | William H. Fournier Jr. | Dentist | 675 Saint Andrews Blvd, Charleston, SC 29407-7343 | 2007-03-05 |
| 1619049475 | Lora Beth Ford | Dentist | 112 Morris St, Charleston, WV 25301-2911 | 2006-11-15 |
| 1316021736 | Donald W Mcvicker | Dentist | 1064 Gardner Lane, Suite 103, Charleston, SC 29407 | 2006-10-24 |
| 1760406565 | John K Kuyk | Dentist | 405 Capitol St, Suite 914, Charleston, WV 25301-1749 | 2006-07-26 |
| 1437797495 | Jeffrey C Kotz Dmd Pa | Dentist | 742 Saint Andrews Blvd, Charleston, SC 29407-7169 | 2019-12-20 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 29407 |
Please comment or provide details below to improve the information on SOUTHEAST ENDODONTICS, PC.
| 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.