DR. THERESA SULLIVAN GONZALES (NPI# 1912969502) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912969502 |
| Entity Type | Individual |
| Full Name | DR. THERESA SULLIVAN GONZALES |
| Credential | DMD, MS |
| Practice Address |
173 Ashley Avenue Msc 507 Charleston SC 29401 |
| Mailing Address |
Po Box 751461 Charlotte NC 28275-1461 |
| Practice Telephone | 8437928723 |
| Practice Fax Number | 8437923697 |
| Mailing Telephone | 8437926200 |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2016-08-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0106X |
Dentist Specialization: Oral and Maxillofacial Pathology |
2648 | SC | Dental Providers |
| N | 1223P0106X |
Dentist Specialization: Oral and Maxillofacial Pathology |
17566 | TX | Dental Providers |
| Street Address |
173 ASHLEY AVENUE MSC 507 |
| City | CHARLESTON |
| State | SC |
| Zip Code | 29401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386162873 | Jonathan Hayes | Registered Nurse | 109 Bee St. Ralph H. Johnson Vamc, Charleston, SC 29401 | 2017-09-05 |
| 1659724904 | M & M Lineberger Dds Ms Pa | Dentist | 347 N. Caswell, Charlotte, NC 29401 | 2016-07-21 |
| 1619375185 | Zach Adams | Specialist/Technologist | 301 Meeting Street, Charleston, SC 29401 | 2014-12-15 |
| 1528469723 | Linda Graber | Occupational Therapist | 75 Calhoun Street, Charleston County Schools, Charleston, SC 29401 | 2014-09-08 |
| 1427497858 | Erika Lynn Wilson | Mechanotherapist | 310 King Street, Charleston, SC 29401 | 2013-06-19 |
| 1730525460 | Mary Beth Hill | Psychologist | 75 Cahoun Street, Charleston, SC 29401 | 2013-05-21 |
| 1699019810 | Chs Psychiatric Associates LLC | Psychiatric Hospital | 255 King Street #8, Charleston, SC 29401 | 2012-11-15 |
| 1255681581 | Parul Olivia Earley | Pharmacist | 59 George St., Charleston, SC 29401 | 2012-09-13 |
| 1669760815 | Dana Leigh Chiulli | Pharmacist | 109 Bee Street (119), Charleston, SC 29401 | 2011-07-20 |
| 1295028959 | Kathleen Anne Waters | Nurse Practitioner | Charleston Center, 5 Charleston Center Drive, Charleston, SC 29401 | 2011-05-26 |
| Find all providers in zip 29401 | ||||
| Taxonomy Code | 1223P0106X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Pathology |
| The specialty of dentistry and discipline of pathology that deals with the nature, identification, and management of diseases affecting the oral and maxillofacial regions. It is a science that investigates the causes, processes, and effects of these diseases. The practice of oral and maxillofacial pathology includes research and diagnosis of diseases using clinical, radiographic, microscopic, biochemical, or other examinations. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639593254 | Medical University of South Carolina | Dentist | 173 Ashley Ave, Charleston, SC 29425-8908 | 2014-02-18 |
| 1194026153 | Medical University of Sc | Dentist | 173 Ashley Ave, Charleston, SC 29425-8908 | 2010-11-08 |
| 1396904405 | Christel Maria Haberland | Dentist | 171 Ashley Ave, Charleston, SC 29425-4804 | 2008-06-03 |
| 1275614828 | Brad Wesley Neville | Dentist | 173 Ashley Ave, Room 544 Bsb, Division of Oral Pathology, Musc, Charleston, SC 29425-5070 | 2006-10-18 |
| 1255304606 | Angela C Chi | Dentist | 173 Ashley Ave, Musc College of Dental Medicine, Charleston, SC 29425-0001 | 2006-02-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407067473 | Northeast Oral & Maxillofacial | Dentist | 1118 Greenlawn Dr, Columbia, SC 29209-2606 | 2007-05-24 |
| 1174656540 | River Falls Oral Surgery | Dentist | 700 Squires Pt, Duncan, SC 29334-8879 | 2007-03-14 |
| 1871606830 | Jonathan M Lafond | Dentist | 455 Old Trolley Rd, Ste E, Summerville, SC 29485-5669 | 2006-08-16 |
| 1982622585 | Derek T Dunlap | Dentist | 700 Squire's Pointe Drive, Suite A, Duncan, SC 29334 | 2006-07-18 |
| 1831156777 | Larry Wayne Cobb | Dentist | 2c Cleveland Ct, Greenville, SC 29607-2414 | 2006-04-26 |
| 1891774162 | Thomas Herbert Simpson Jr. | Dentist | 372 S Herlong Ave, Rock Hill, SC 29732 | 2006-01-13 |
| 1518177807 | Orangeburg Oral Surgery & Implant Center | Dentist | 1175 Cook Rd, Ste 135, Orangeburg, SC 29118-8201 | 2007-05-23 |
| 1619008547 | Greenville Oral Surgery, P.a. | Dentist | 3929 S Highway 14, Greenville, SC 29615-6138 | 2007-03-09 |
| 1700916822 | Northeast Oral & Maxillofacial Surgery Center | Dentist | 9310 Two Notch Rd, Columbia, SC 29223-6416 | 2007-03-07 |
| 1801976162 | Kenneth M. Burtner | Dentist | 105 Ben Casey Dr, Suite 115, Fort Mill, SC 29708-8561 | 2006-10-17 |
| Find all providers with the same taxonomy | ||||
| City | CHARLESTON |
| Zip Code | 29401 |
Please comment or provide details below to improve the information on DR. THERESA SULLIVAN GONZALES.
| 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.