DENTAL WELLNESS CENTER OF IRMO, LLC (NPI# 1407314404) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407314404 |
| Entity Type | Organization |
| Organization Name | DENTAL WELLNESS CENTER OF IRMO, LLC |
| Practice Address |
2724 N Lake Dr Ste 304 Columbia SC 29212-8733 |
| Mailing Address |
Po Box 60339 Savannah GA 31420-0339 |
| Practice Telephone | 8888858492 |
| Practice Fax Number | 9122263489 |
| Mailing Telephone | 8888858492 |
| Mailing Fax Number | 9122263489 |
| Enumeration Date | 2019-03-08 |
| Last Update Date | 2019-06-11 |
| Authorized Official Name | MRS. CHRISTIE D LAWRENCE (CORPORATE OPERATIONS COORDINATOR) |
| Authorized Official Telephone | 9129205577 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | STATE LICENSE | DN010747 | 01 |
| GA | NPI | 1497918759 | 01 |
| Street Address |
2724 N LAKE DR STE 304 |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29212-8733 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336787811 | Dental Wellness Center Eb5 Investment Vi LLC | Dentist | 2724 N Lake Dr Ste 304, Columbia, SC 29212-8733 | 2019-12-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245758887 | Amanda Gail Holloman | Pharmacist | 6021 St. Andrews Road, Columbia, SC 29212 | 2017-09-04 |
| 1578080180 | Alvin Mitchell Jr. | Non-emergency Medical Transport (VAN) | 10 Breezewood Court, Columbia, SC 29212 | 2017-08-24 |
| 1467975102 | Shelby Clemmer | Behavior Technician | 2 Harbison Way, Columbia, SC 29212 | 2017-07-25 |
| 1982149019 | Showntellem | Private Vehicle | 336 Foxfire Dr, Columbia, SC 29212 | 2016-12-28 |
| 1902215296 | Miranda Willis Adult Day Care, LLC | Social Worker | 5932 Mcmillian Circle, Columbia, SC 29212 | 2014-08-12 |
| 1013342591 | Robert Glendon Long | Pediatrics | 15 Woodpine Ct, Columbia, SC 29212 | 2013-09-04 |
| 1174969638 | Melinda Dumas Crenshaw | Psychologist | 2800 Ashland Rd., Columbia, SC 29212 | 2013-05-10 |
| 1417209982 | Physician Services LLC | Internal Medicine | 214 Lake Front Drive, Physician Services, Cola, SC 29212 | 2012-10-09 |
| 1306131800 | Rocky Mountain Holdings LLC | Ambulance | 6015 Saint Andrews Rd, Columbia, SC 29212 | 2011-06-13 |
| 1023262839 | Candace Anne Aguiar | Nurse Anesthetist, Certified Registered | 400 Palmetto Health Pkwy, Palmetto Health Baptist Parkridge, Columbia, SC 29212 | 2008-11-06 |
| Find all providers in zip 29212 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306444740 | Ressel Family Dentistry LLC | Clinic/Center | 1 E Broadway Ste A, Columbia, MO 65203-4205 | 2020-10-16 |
| 1578175733 | Columbia Dental LLC | Clinic/Center | 846 Lancaster Ave, Columbia, PA 17512-2206 | 2020-08-19 |
| 1386256931 | B. Casey Crafton Dds Ms PC | Clinic/Center | 10380 Old Columbia Rd, Columbia, MD 21046-1882 | 2020-08-17 |
| 1497307730 | Robert C Wilhite Jr Dds Pllc | Clinic/Center | 1300 Hatcher Ln Ste 1, Columbia, TN 38401-3554 | 2019-07-16 |
| 1609335066 | Dentistry for Children of Maryland, LLC | Clinic/Center | 8600 Snowden River Pkwy Ste 302, Columbia, MD 21045-1985 | 2019-03-15 |
| 1386101459 | Columbia Dental Health Clinic | Clinic/Center | 2750 Laurel St Ste 202, Columbia, SC 29204-2024 | 2019-02-26 |
| 1821580622 | Columbia Smiles Downtown | Clinic/Center | 1310 Lady St Ste 600, Columbia, SC 29201-3327 | 2018-06-06 |
| 1427548353 | Simply Smile Pa | Clinic/Center | 7457 Patterson Rd Ste 107, Columbia, SC 29209-0710 | 2018-05-16 |
| 1477055481 | Southern Smiles Dental Studio Columbia LLC | Clinic/Center | 160 Summit Centre Dr, Columbia, SC 29229-7612 | 2018-03-06 |
| 1417462904 | Maryland Smile Center | Clinic/Center | 9520 Berger Rd Ste 303-305, Columbia, MD 21046-1501 | 2017-12-06 |
| Find all providers in COLUMBIA | ||||
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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.