DR. TAVIS M SISSON (NPI# 1497195549) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497195549 |
| Entity Type | Individual |
| Full Name | DR. TAVIS M SISSON |
| Credential | D.M.D. |
| Practice Address |
1350 Grove Park Dr Orangeburg SC 29115-2455 |
| Practice Telephone | 8555288410 |
| Mailing Telephone | 8555288410 |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2013-10-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223G0001X |
Dentist Specialization: General Practice |
DN 20224 | FL | Dental Providers |
| Y | 1223G0001X |
Dentist Specialization: General Practice |
DGD.8284 GD | SC | Dental Providers |
| Street Address |
1350 GROVE PARK DR |
| City | ORANGEBURG |
| State | SC |
| Zip Code | 29115-2455 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043457799 | Randolph Charles Bryson | Dentist | 1350 Grove Park Dr, Orangeburg, SC 29115-2455 | 2009-01-17 |
| 1538645130 | Ryan James Herald | Dentist | 1350 Grove Park Dr, Orangeburg, SC 29115-2455 | 2018-07-17 |
| 1063708410 | Kool Smiles Sc-2, PC | Dentist | 1350 Grove Park Dr, Orangeburg, SC 29115-2455 | 2011-06-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306326640 | Orange Cut Rate Drug Store, Inc | General Practice | 1326 Grove Park Dr, Orangeburg, SC 29115 | 2018-08-16 |
| 1821528639 | Shonta Tenisha Westbury | Speech-Language Pathologist | 1890 Dellwood Drive, Orangeburg, SC 29115 | 2017-06-14 |
| 1356870794 | All Your Needs Home Care Services, LLC | Respite Care | 133 Boulevard Street, Orangeburg, SC 29115 | 2017-06-08 |
| 1376090860 | Hanna Bozard | Pharmacist | 332 Stone Wall Jackson Blvd, Orangeburg, SC 29115 | 2016-09-01 |
| 1417309956 | Marian Mitchell Oliver Corp. | Dentist | 939 Jc Calhoun Drive, Orangeburg, SC 29115 | 2016-07-08 |
| 1750766119 | Holly Able | Pharmacist | 332 Stonewall Jackson Blvd., Orangeburg, SC 29115 | 2015-07-28 |
| 1104211234 | Sheryl Durant Singleton | Nurse Practitioner | 1857 Joe S Jeffords Hwy, Orangeburg, SC 29115 | 2015-04-06 |
| 1982012696 | Jeremy Morry Eith | Specialist/Technologist | 300 College Street, Orangeburg, SC 29115 | 2014-07-25 |
| 1629495841 | Kathy Beeks | Registered Nurse | 1550 Carolina Avenue, Carolina Avenue, Orangeburg, SC 29115 | 2014-03-26 |
| 1538509534 | Thomas Charles Haynes Jr. | Audiologist | 1655 Carolina Ave., Orangeburg, SC 29115 | 2013-07-05 |
| Find all providers in zip 29115 | ||||
| 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 |
|---|---|---|---|---|
| 1851752810 | Gamble Dentalsmart PC | Dentist | 403 Stonewall Jackson Blvd, Orangeburg, SC 29115-7282 | 2016-03-17 |
| 1043457799 | Randolph Charles Bryson | Dentist | 1350 Grove Park Dr, Orangeburg, SC 29115-2455 | 2009-01-17 |
| 1285859348 | United Dental Group, LLC | Dentist | 4215 North Rd, Orangeburg, SC 29118-1128 | 2007-04-16 |
| 1497887491 | Michael Everette Salley | Dentist | 924 Bennett St, Orangeburg, SC 29115-4214 | 2007-03-12 |
| 1356491435 | William Eugene Atkinson | Dentist | 1681 Carolina Ave, Orangeburg, SC 29115-4939 | 2007-01-11 |
| 1053472563 | Robert A. Varn | Dentist | 695 Laurel St, Orangeburg, SC 29115-4834 | 2006-12-12 |
| 1043378870 | L Jarrette Burckhalter Iv | Dentist | 1643 Carolina Avenue, Orangeburg, SC 29115 | 2006-12-05 |
| 1932130606 | Dwight Delano Mcmillan Jr. | Dentist | 939 Calhoun Drive, Orangeburg, SC 29115-6763 | 2006-07-05 |
| 1770538209 | John W. Rheney IIi | Dentist | 882 Cook Road, Orangeburg, SC 29118-2126 | 2006-05-23 |
| 1912964354 | Murtuza Ansari | Dentist | 1340 Park St, Orangeburg, SC 29115-4880 | 2006-04-28 |
| Find all providers in ORANGEBURG | ||||
| City | ORANGEBURG |
| Zip Code | 29115 |
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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.