CAROLINA AESTHETIC DENTISTRY PA (NPI# 1922115658) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922115658 |
| Entity Type | Organization |
| Organization Name | CAROLINA AESTHETIC DENTISTRY PA |
| Practice Address |
383 South Pine Street Suite 3 Spartanburg SC 29302 |
| Practice Telephone | 8645779400 |
| Practice Fax Number | 8645779773 |
| Mailing Telephone | 8645779400 |
| Mailing Fax Number | 8645779773 |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. KATHERINE MELISSA NICHOLSON (DENTIST) |
| Authorized Official Telephone | 8645779400 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
SC3390 | SC | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 233900 | 05 | |
| SC | ZA9539 | 05 |
| Street Address |
383 SOUTH PINE STREET SUITE 3 |
| City | SPARTANBURG |
| State | SC |
| Zip Code | 29302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083226476 | Healthstat Inc Grace Management | Preventive Medicine | 951 South Pin Street, Suite 200, Spartanburg, SC 29302 | 2020-08-18 |
| 1467978304 | Katherine Tomes | Speech-Language Pathologist | 355 Cedar Springs Road, Spartanburg, SC 29302 | 2017-08-22 |
| 1396291167 | Brent Timothy Smith | Specialist | 151 Ribault Street Suite 200, Spartanburg, SC 29302 | 2016-08-31 |
| 1376995159 | Natalie Nicole Kellett | Nurse Practitioner | 120 Heywood Avenue Suite 200, Spartanburg, SC 29302 | 2016-07-06 |
| 1902273808 | Tamieka Latrell Alston-gibson | Nurse Practitioner | 101 North Pine Street, Suite 210, Spartanburg, SC 29302 | 2015-08-26 |
| 1700209905 | Robert W Wyatt | Pharmacist | 203 Cedar Springs Rd, Spartanburg, SC 29302 | 2014-01-24 |
| 1952735748 | James Sidney Fulmer Sr. | Obstetrics & Gynecology | 167 Ivy Court, Spartanburg, SC 29302 | 2013-08-28 |
| 1053651828 | Jennifer Geddes Hall | Counselor | 101 N Pine St Ste 210, Spartanburg, SC 29302 | 2013-02-15 |
| 1487875514 | Park Place Spartanburg | Assisted Living Facility | 2720 Country Clud Road, Spartanburg, SC 29302 | 2007-05-02 |
| 1740304401 | Leon Derek Herring | Dentist | 270 Cedar Spring Rd, Spartanburg, SC 29302 | 2007-03-19 |
| Find all providers in zip 29302 | ||||
| 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 |
|---|---|---|---|---|
| 1194873653 | Michael A. Zimmerman | Dentist | 127 Southport Rd, Spartanburg, SC 29306-3815 | 2007-01-08 |
| 1033227772 | William Miller Edwards | Dentist | 154 Country Club Rd, Spartanburg, SC 29302 | 2006-08-25 |
| 1508473265 | Upstate Endodontics, Inc. | Dentist | 263 California Ave, Spartanburg, SC 29303-2271 | 2020-09-28 |
| 1427336239 | Brett W. Hill | Dentist | 154 Country Club Rd, Spartanburg, SC 29302-3364 | 2011-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710442967 | Central Carolina Endodontics Pa | Dentist | 888 Cook Road, Orangeburg, SC 29118 | 2019-02-01 |
| 1881007946 | Intercoastal Endo, PC | Dentist | 4382 Oleander Dr, Myrtle Beach, SC 29577 | 2014-06-06 |
| 1568775468 | Kool Smiles Sc-2, PC | Dentist | 5422 Forest Dr, Columbia, SC 29206-5412 | 2010-07-20 |
| 1992018899 | Kool Smiles Sc-2, PC | Dentist | 4400 Dorchester Rd Ste 108, Charleston, SC 29405-6863 | 2010-07-20 |
| 1912230335 | Omar James Jones IIi | Dentist | 237 Plantation Dr, Manning, SC 29102-9504 | 2009-09-16 |
| 1972733624 | Robert P Bethea | Dentist | 34 Lakeview Cir, Columbia, SC 29206-3214 | 2009-07-15 |
| 1295975977 | Jason H. Cohen, Dmd, LLC | Dentist | 198 Rutledge Ave Ste 3, Charleston, SC 29403-5834 | 2009-02-20 |
| 1508029554 | Gavin L Criser | Dentist | 220 Cherokee Rd Ste B, Florence, SC 29501-5225 | 2008-07-09 |
| 1912188525 | Michael Eugene Piepenbring | Dentist | 1109 Memorial Ln Ste B, Georgetown, SC 29440-3369 | 2007-11-26 |
| 1962600437 | Michael John Pfister | Dentist | 101 Finley St, Clemson, SC 29631-1583 | 2007-07-06 |
| Find all providers with the same taxonomy | ||||
| City | SPARTANBURG |
| Zip Code | 29302 |
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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.