CAROLINA CENTER FOR RESTORATIVE DENTISTRY (NPI# 1447360854) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447360854 |
| Entity Type | Organization |
| Organization Name | CAROLINA CENTER FOR RESTORATIVE DENTISTRY |
| Practice Address |
966 Suite I Houston Northcutt Blvd Mt Pleasant SC 29464 |
| Practice Telephone | 8438499044 |
| Practice Fax Number | 8438497493 |
| Mailing Telephone | 8438499044 |
| Mailing Fax Number | 8438497493 |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. KENNETH STEVEN BARRACK (PARTNER PRESIDENT) |
| Authorized Official Telephone | 8438499044 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 1223P0300X |
Dentist Specialization: Periodontics |
183 | SC | Dental Providers |
| X | 1223P0700X |
Dentist Specialization: Prosthodontics |
4169621 | SC | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TPIN | 45955353 | 01 |
| Street Address |
966 SUITE I HOUSTON NORTHCUTT BLVD |
| City | MT PLEASANT |
| State | SC |
| Zip Code | 29464 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811548241 | Bradley Paul Anuszkiewicz | Chiropractor | 1501 Johnnie Dodds Blvd, Suite C, Mount Pleasant, SC 29464 | 2019-09-26 |
| 1447808696 | Laura Mariah Crouse | Speech-Language Pathologist | Coastal Therapy Services, 1127 Queensborough Blvd, Mt Pleasant, SC 29464 | 2019-08-30 |
| 1912461807 | Independent Optical | Optometrist | 1710 Shoremead Rd, Suite 420, Mount Pleasant, SC 29464 | 2019-01-25 |
| 1417446204 | Michael Adam Sugarman | Clinical Neuropsychologist | 1459 Stuart Engals Blvd Ste 204a, Mt Pleasant, SC 29464 | 2018-05-07 |
| 1578064192 | Ancillary Specialists LLC | Durable Medical Equipment & Medical Supplies | 636 Long Point Road, Unit G, #19, Mount Pleasant, SC 29464 | 2018-02-28 |
| 1346769015 | Christin Solomon Zerega | Counselor | Lowcountry Psychiatry Group, 913 Bowman Rd, #4, Mount Pleasant, SC 29464 | 2017-09-14 |
| 1336660315 | Charleston Neuropsychology LLC | Psychologist | 1459 Stuart Engals Blvd., Suite 204a, Mount Pleasant, SC 29464 | 2017-06-29 |
| 1790219970 | Adam Hudepohl | Family Medicine | 1400 Ben Sawyer Blvd, Mt Pleasant, SC 29464 | 2017-04-14 |
| 1386181204 | Alicia Taylor | Speech-Language Pathologist | 381 Stonewall Ct Apt 6207, Mount Pleasant, SC 29464 | 2017-01-30 |
| 1285181941 | Tara Lynn Mast | Physical Therapist | 1400 Caliper Oak Circle, Apt 316, Mount Pleasant, SC 29464 | 2016-09-09 |
| Find all providers in zip 29464 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750304176 | Elizabeth Jane Bjornson | Dentist | 1321 Chuck Dawley Blvd, Suite 101, Mt Pleasant, SC 29464-7304 | 2006-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851918882 | E.l. Centre Pointe Professional LLC | Dentist | 4965 Centre Pointe Dr Ste 100, North Charleston, SC 29418-6945 | 2020-06-25 |
| 1568084408 | Diane Jenkins Periodontics of Congaree, LLC | Dentist | 600 Congaree Rd, Greenville, SC 29607-3518 | 2020-05-14 |
| 1275016263 | R.e. Offutt, Dds, Ms and B.l. Cockerham Dds, Msp, Pllc | Dentist | 929 Market St, Fort Mill, SC 29708 | 2018-09-14 |
| 1447769831 | Beaufort Oral and Facial Surgery, LLC | Dentist | 968 Ribaut Rd Ste 3, Beaufort, SC 29902-8002 | 2017-09-28 |
| 1487184727 | Hillary Nona Wright | Dentist | 1064 Gardner Rd Ste 110, Charleston, SC 29407-5711 | 2017-06-19 |
| 1649725102 | Carolina Periodontics & Dental Implants | Dentist | 112 W Broad St Unit 405, Greenville, SC 29601-2688 | 2016-08-24 |
| 1649630492 | Samir Dilip Patel | Dentist | 342 Patricia Ln Ste 103, Fort Mill, SC 29708-6608 | 2016-03-07 |
| 1225410558 | Happy Teeth Happy Kids, LLC | Dentist | 3074 Deville St, Myrtle Beach, SC 29577-1569 | 2015-06-23 |
| 1750783338 | Frank C. Sparacino Dds Mhs PC | Dentist | 8800 Northpark Blvd, North Charleston, SC 29406-9226 | 2014-09-25 |
| 1346682754 | Tyresia Jovon White | Dentist | 440 Society Hill Dr Ste 201, Aiken, SC 29803 | 2013-07-25 |
| Find all providers with the same taxonomy | ||||
| City | MT PLEASANT |
| Zip Code | 29464 |
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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.