POWDERSVILLE PEDIATRIC DENTISTRY, PA (NPI# 1417965922) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417965922 |
| Entity Type | Organization |
| Organization Name | POWDERSVILLE PEDIATRIC DENTISTRY, PA |
| Practice Address |
10705 Anderson Road Easley SC 29642 |
| Practice Telephone | 8642205437 |
| Practice Fax Number | 8642200420 |
| Mailing Telephone | 8642205437 |
| Mailing Fax Number | 8642200420 |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2013-09-09 |
| Authorized Official Name | DR. MELANIE RICHARDS (OWNER PRESIDENT) |
| Authorized Official Telephone | 8642205437 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
3152 | SC | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | BLUE CROSS BLUE SHIELD | 3126152 | 01 |
| ANTHEM BLUE CROSS | 214665 | 01 | |
| UNITED CONCORDIA | 706109 | 01 | |
| AL | BLUE CROSS BLUE SHIELD | 88009615 | 01 |
| SC | ZA9574 | 05 |
| Street Address |
10705 ANDERSON ROAD |
| City | EASLEY |
| State | SC |
| Zip Code | 29642 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093316911 | Marlesia Hall | Licensed Practical Nurse | 106 Teal Dr, Easley, SC 29642 | 2020-11-06 |
| 1437648904 | Onsite Healthcare and Wellness LLC | Nurse Practitioner | 217 Sheffield Ct, Easley, SC 29642 | 2018-05-09 |
| 1477073476 | Aubre True | Specialist/Technologist | 124 Century Oaks Dr, Easley, SC 29642 | 2017-06-21 |
| 1912439944 | First Physical Therapy, LLC | Clinic/Center | 3613 Sc 153, Suite 200, Powdersville, SC 29642 | 2017-03-29 |
| 1801146485 | Sara Michele Calvert | Pharmacist | 1063 South Pendleton Street, Easley, SC 29642 | 2012-09-11 |
| 1023365251 | Heather Lilley | Pharmacist | 5251 Calhoun Memorial Hwy, Easley, SC 29642 | 2012-08-07 |
| 1942590088 | Mallorie Bryan Costner | Speech-Language Pathologist | 507 Huntington Road, Easley, SC 29642 | 2011-04-11 |
| 1225352339 | Jon Lawrence Rhoden | Pharmacist | 320 Watson Road, Easley, SC 29642 | 2010-03-18 |
| 1386865350 | Gordon David Dannelly | Dentist | 701 Brushy Creek Road, Easley, SC 29642 | 2007-05-01 |
| 1538280755 | Michelle Leigh Tucker | Obstetrics & Gynecology | 1351 Crestview Road, Easley, SC 29642 | 2007-04-03 |
| Find all providers in zip 29642 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194181297 | Holly Tree Family Dental | Dentist | 1673 E Main St, Easley, SC 29640-3791 | 2016-01-06 |
| 1609282425 | Rula Mahmoud Shalabi | Dentist | 1673 E Main St Unit B, Easley, SC 29640-3791 | 2014-07-02 |
| 1699965418 | Melanie Richards | Dentist | 10705 Anderson Rd, Easley, SC 29642-9309 | 2007-07-27 |
| 1649832510 | Igrin Children's Dentistry of Powdersville, LLC | Dentist | 10705 Anderson Rd, Easley, SC 29642-8298 | 2019-07-01 |
| 1174082713 | Indigo Pediatric Dentistry | Dentist | 1673 E Main St Unit B, Easley, SC 29640-3791 | 2019-03-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811598493 | Pleasant Mill Pediatric Dentistry | Dentist | 1690 Highway 160 W Ste A, Fort Mill, SC 29708-8024 | 2020-11-02 |
| 1124635495 | Destination Dental of Duncan LLC | Dentist | 155 Deacon Tiller Ct, Duncan, SC 29334-8880 | 2020-09-30 |
| 1487267365 | Cp Dentistry, LLC | Dentist | 9919 Dorchester Road, Summerville, SC 29485 | 2020-08-28 |
| 1811519507 | Stephanie Silva Dmd, LLC | Dentist | 133 Allen Court, North Augusta, SC 29860 | 2020-05-15 |
| 1235776568 | Tribe Dental LLC | Dentist | 11 Magnolia Cove Dr, Simpsonville, SC 29680 | 2019-12-05 |
| 1457994196 | Sfd Mt. Pleasant LLC | Dentist | 3102 N Highway 17, Mount Pleasant, SC 29466-6925 | 2019-10-25 |
| 1073162053 | Southern Charm Pediatric Dentistry | Dentist | 2021 Bridgemill Rd., Suite 108, Indian Land, SC 29707-2817 | 2019-09-11 |
| 1649825969 | Oak Landing Pediatric Dentistry, LLC | Dentist | 2001 2nd Ave Ste 102, Summerville, SC 29486-7887 | 2019-08-04 |
| 1851858013 | The Tot Spot of South Carolina | Dentist | 1334 S. Hwy 14, Simpsonville, SC 29681 | 2019-02-25 |
| 1588130942 | Dentistry for Children of South Carolina PC | Dentist | 1701 Beaucastel Rd Ste A, Mount Pleasant, SC 29464-3685 | 2018-10-23 |
| Find all providers with the same taxonomy | ||||
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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.