DENTAL PROFESSIONALS OF SOUTH CAROLINA, PC (NPI# 1972894251) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972894251 |
| Entity Type | Organization |
| Organization Name | DENTAL PROFESSIONALS OF SOUTH CAROLINA, PC |
| Other Organization Name | EASTSIDE GENERAL DENTISTRY |
| Practice Address |
2445 E Main St Spartanburg SC 29307-1415 |
| Practice Telephone | 8645797833 |
| Practice Fax Number | 8645905364 |
| Mailing Telephone | 8645797833 |
| Mailing Fax Number | 8645905364 |
| Enumeration Date | 2011-04-21 |
| Last Update Date | 2011-04-21 |
| Authorized Official Name | KAM SHICK (INSURANCE COORDINATOR) |
| Authorized Official Telephone | 2175405141 |
| Is Organization Subpart | Y |
| Parent Organization Name | DENTAL PROFESSIONALS OF SOUTH CAROLINA, PC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Eastside General Dentistry | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295195188 | Dental Professionals of South Carolina, PC | Dentist | 615 St. James Ave, Goose Creek, SC 29445 | 2016-03-04 |
| 1487013108 | Dental Professionals of South Carolina, PC | Dentist | 340 Harrison Bridge Rd, Suite D, Simpsonville, SC 29680-7133 | 2016-02-23 |
| 1609241033 | Dental Professionals of South Carolina, PC | Dentist | 9510 Dorchester Rd, Suite 400, North Charleston, SC 29485 | 2015-12-10 |
| 1871964015 | Dental Professionals of South Carolina, PC | Dentist | 1028 Edgewater Corp. Pkwy, Suite 101, Indian Land, SC 29707 | 2015-10-14 |
| 1053706747 | Dental Professionals of South Carolina, PC | Dentist | 100 Debo Dr Unit 110, Myrtle Beach, SC 29579-4921 | 2015-03-31 |
| Street Address |
2445 E MAIN ST |
| City | SPARTANBURG |
| State | SC |
| Zip Code | 29307-1415 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881737799 | Walter R. Leonard | Dentist | 2445 E Main St, Spartanburg, SC 29307-1415 | 2007-02-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023677945 | Healogics Specialty Physicians of South Carolina, LLC | Clinic/Center | 1630 Skylyn Drive, Suite 420, Spartanburg, SC 29307 | 2019-06-13 |
| 1194247528 | Tawnia Lee Prince | Occupational Therapy Assistant | 110 Summit Knoll Drive, Spartanburg, SC 29307 | 2017-07-07 |
| 1730633553 | Laura K Taylor | Chiropractor | 1802 Drayton Road, Suite 309, Spartanburg, SC 29307 | 2016-08-10 |
| 1013372390 | Erin Lavette Farr | Nurse Practitioner | 2780 East Main Street, Ltc Health Solutions, Spartanburg, SC 29307 | 2015-12-30 |
| 1316312010 | Joy Rogers | Speech-Language Pathologist | 175 Burdette St, Spartanburg, SC 29307 | 2015-12-07 |
| 1376923169 | Olivia Conrad | Speech-Language Pathologist | 220 Sloans Grove Rd, Spartanburg, SC 29307 | 2015-06-05 |
| 1457755118 | Optimal Radiology Partners of Virginia, Pllc | Radiology | 75 Skylyn Drive, Spartanburg, SC 29307 | 2014-10-09 |
| 1295033272 | Sean Quinn | Pharmacist | 790 East Main Street, Spartanburg, SC 29307 | 2011-03-01 |
| 1417250887 | James Edward Bradof | Internal Medicine | 212 Cypress Creek Drive, Spartanburg, SC 29307 | 2010-12-07 |
| 1528388030 | Tanya Tocharoen Tang | Internal Medicine | 126 Dillon Dr., Spartanburg, SC 29307 | 2010-06-07 |
| Find all providers in zip 29307 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891312039 | Prince B Moses | Dentist | 631 N Church St, Spartanburg, SC 29303-3046 | 2020-07-04 |
| 1316563133 | Todd Garrett Woollen | Dentist | 272 Cedar Springs Rd, Spartanburg, SC 29302-4643 | 2020-06-17 |
| 1790207801 | Pine Street Dental LLC | Dentist | 364 S Pine St Ste A101, Spartanburg, SC 29302-2654 | 2017-07-10 |
| 1932566197 | Gamble Dentalsmart PC | Dentist | 2127 E Main St, Suite E, Spartanburg, SC 29307-1454 | 2016-01-19 |
| 1437524469 | Hillcrest Family and Cosmetic Dentistry, LLC | Dentist | 2088 E Main St, Suite A & B, Spartanburg, SC 29307-1425 | 2015-12-02 |
| 1942601174 | Carolina Dental Docs LLC General Dentistry for Kids | Dentist | 1460 John B White Sr Blvd, Ste 1-c, Spartanburg, SC 29306 | 2014-09-08 |
| 1770915530 | Steven Andrew Richards | Dentist | 270 Cedar Springs Rd, Spartanburg, SC 29302-4654 | 2013-08-05 |
| 1659609485 | Regenesis Organzation Community Health Center | Dentist | 550 S Church Street, Unit 2, Spartanburg, SC 29306-3306 | 2009-12-07 |
| 1396972618 | Paul Michael Gibas Jr. | Dentist | 1585 Skylyn Drive, Spartanburg, SC 29307 | 2009-06-12 |
| 1225285646 | Radiant Dentistry | Dentist | 1440 Fernwood Glendale Rd, Spartanburg, SC 29307-3079 | 2008-08-27 |
| Find all providers in SPARTANBURG | ||||
| City | SPARTANBURG |
| Zip Code | 29307 |
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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.