COASTAL KIDS DENTAL & BRACES (NPI# 1932598331) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932598331 |
| Entity Type | Organization |
| Organization Name | COASTAL KIDS DENTAL & BRACES |
| Practice Address |
216 E Main St Moncks Corner SC 29461-3709 |
| Mailing Address |
808 Wappoo Rd Charleston SC 29407-5865 |
| Practice Telephone | 8438185437 |
| Practice Fax Number | 8437251594 |
| Mailing Telephone | 8438185437 |
| Mailing Fax Number | 8437251594 |
| Enumeration Date | 2015-01-22 |
| Last Update Date | 2015-01-22 |
| Authorized Official Name | JACOB DRIGGERS (COO) |
| Authorized Official Telephone | 8438185437 |
| Is Organization Subpart | Y |
| Parent Organization Name | COASTAL KIDS DENTAL, PA |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
4209 | SC | Dental Providers |
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
4476 | SC | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598154999 | Coastal Kids Dental & Braces | Dentist | 1000 Tanner Ford Blvd, Ste 370, Hanahan, SC 29410-4707 | 2015-01-22 |
| 1124417522 | Coastal Kids Dental & Braces | Dentist | 8600 Dorchester Rd, Ste 104, North Charleston, SC 29420-7382 | 2015-01-22 |
| 1841689247 | Coastal Kids Dental & Braces | Dentist | 808 Wappoo Rd, Charleston, SC 29407-5865 | 2015-01-22 |
| 1376932798 | Coastal Kids Dental & Braces | Dentist | 118 S Walter St, Walterboro, SC 29488-3956 | 2015-01-22 |
| Street Address |
216 E MAIN ST |
| City | MONCKS CORNER |
| State | SC |
| Zip Code | 29461-3709 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841554979 | Kenneth Zamora | Dentist | 216 E Main St, Moncks Corner, SC 29461-3709 | 2012-07-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982267605 | Berkeley Citizens Inc | Early Intervention Provider Agency | P0 Drawer 429 1301 Old Hwy 52 South, Moncks Corner, SC 29461 | 2019-04-18 |
| 1376015222 | Anthony Johnson | Counselor | 306 Airport Drive, Moncks Corner, SC 29461 | 2018-12-17 |
| 1598243719 | Jana Matthews Chinners | Family Medicine | 2061 Us-52, Moncks Corner, SC 29461 | 2018-07-31 |
| 1285151225 | Nathan Andrew Bostrom | Occupational Therapist | 118 Carolina Avenue, Moncks Corner, SC 29461 | 2017-08-29 |
| 1942730528 | Martina Snider | Specialist | 393 Corner Square Plaza, Moncks Corner, SC 29461 | 2017-06-15 |
| 1104355502 | Mary Elizabeth Perdue | Counselor | 306 Airport Dr., Moncks Corner, SC 29461 | 2017-06-08 |
| 1619390481 | Berkeley Citizens, Inc. | Public Health or Welfare | 1301 Old Hwy. 52 South, Moncks Corner, SC 29461 | 2014-01-29 |
| 1326384082 | Amanda Trueworthy | Counselor | 3156 F South Live Oak Drive, Moncks Corner, SC 29461 | 2012-12-27 |
| 1790040202 | Melanie Mcendree | Community Health Worker | 105 Lobolly Dr., Moncks Corner, SC 29461 | 2012-07-10 |
| 1891093845 | Leslie Erin Blackmon Stelling | Pharmacist | 110 South Highway 52, Moncks Corner, SC 29461 | 2011-02-28 |
| Find all providers in zip 29461 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487044632 | Lindsay E Grosso | Dentist | 421 Barony St Ste 6, Moncks Corner, SC 29461-3145 | 2015-01-27 |
| 1760404081 | Michael Frank Grosso Jr. | Dentist | 421 Barony St, Suite 6, Moncks Corner, SC 29461-3145 | 2006-07-24 |
| 1366805152 | Grosso Orthodontics | Dentist | 421 Barony St Ste 6, Moncks Corner, SC 29461-3145 | 2016-03-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194332619 | Candid South Carolina, P.C. | Dentist | 136-4 Forum Drive #a20, Columbia, SC 29229 | 2020-09-29 |
| 1518570902 | Foster Orthodontics, Pa | Dentist | 100 Hamlet Cir, Goose Creek, SC 29445-7111 | 2020-08-26 |
| 1740893122 | Foster Orthodontics, Pa | Dentist | 625 Skylark Dr, Charleston, SC 29407-5782 | 2020-08-26 |
| 1629602065 | Keith William Street | Dentist | 1460 John B White Sr Blvd Ste 1-5, Spartanburg, SC 29306-3996 | 2020-02-25 |
| 1225678931 | Rekha Wadhwa | Dentist | 100 Woodruff Place Cir, Simpsonville, SC 29681-3672 | 2020-01-10 |
| 1952965345 | Align America Sc, LLC | Dentist | 259 Textile Way Ste 103, Fort Mill, SC 29715-4550 | 2019-05-01 |
| 1952865289 | Orthodontic Specialists of Carolina, PC | Dentist | 611 Haywood Road, Greenville, SC 29607 | 2019-01-31 |
| 1699267021 | Trevan Samp | Dentist | 22 Westedge St Ste 106b, Charleston, SC 29403-6983 | 2018-06-01 |
| 1548759244 | Smile Doctors of South Carolina, P.C. | Dentist | 105 Ben Casey Dr Ste 109, Fort Mill, SC 29708-8557 | 2018-05-08 |
| 1386158541 | Katherine Dean Solomon | Dentist | 102 Buckwalter Pkwy Ste 3j, Bluffton, SC 29910-4130 | 2017-11-27 |
| Find all providers with the same taxonomy | ||||
| City | MONCKS CORNER |
| Zip Code | 29461 |
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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.