DR. MARK LANE MCENTIRE (NPI# 1558595074) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1558595074 |
Entity Type | Individual |
Full Name | DR. MARK LANE MCENTIRE |
Credential | D.M.D. |
Practice Address |
173 Ashley Ave Charleston SC 29425-8908 |
Mailing Address |
1025 Riverland Woods Pl Apt 906 Charleston SC 29412-4141 |
Practice Telephone | 8437922880 |
Mailing Telephone | 8039243857 |
Enumeration Date | 2009-05-12 |
Last Update Date | 2009-05-12 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223P0300X |
Dentist Specialization: Periodontics |
4488 | SC | Dental Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1073626610 | Mark Douglas Mcentire | Physical Therapist | 6499 Mason-montgomery Road, Suite D, Mason, OH 45040 | 2006-08-17 |
Street Address |
173 ASHLEY AVE |
City | CHARLESTON |
State | SC |
Zip Code | 29425-8908 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053303966 | Mullen O Coover | Dentist | 173 Ashley Ave, Bsb-335, Charleston, SC 29425-8908 | 2005-08-17 |
1093331472 | Austin Anthony Hughes | Dentist | 173 Ashley Ave, Charleston, SC 29425-8908 | 2020-06-22 |
1205489739 | Frances Gouldin | Dentist | 173 Ashley Ave, Charleston, SC 29425-8908 | 2019-07-23 |
1093105579 | Timothy Rohde | Dentist | 173 Ashley Ave, Bsb 546, Msc 507, Charleston, SC 29425-8908 | 2015-02-04 |
1639593254 | Medical University of South Carolina | Dentist | 173 Ashley Ave, Charleston, SC 29425-8908 | 2014-02-18 |
1194026153 | Medical University of Sc | Dentist | 173 Ashley Ave, Charleston, SC 29425-8908 | 2010-11-08 |
1780902734 | Jompobe Vuthiganon | Dentist | 173 Ashley Ave, Bsb Rm 546, Charleston, SC 29425-8908 | 2010-05-13 |
1902069271 | Michael Kinon Lecholop | Dentist | 173 Ashley Ave, Charleston, SC 29425-8908 | 2008-07-08 |
1174708010 | Frederick Thomas Moore | Dentist | 173 Ashley Ave, Bsb 249, Charleston, SC 29425-8908 | 2008-01-09 |
1952517161 | Musc College of Dental Medicine | Clinic/Center | 173 Ashley Ave, Bsb 246, Charleston, SC 29425-0001 | 2007-05-15 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1922607217 | Krishna Bhandari | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 10 Mcclennan Banks Drive, 2190-r, Msc 918, Charleston, SC 29425 | 2020-10-19 |
1649892456 | Mary Macrae Lynch | Social Worker | 179 Ashley Avenue, Charleston, SC 29425 | 2020-05-14 |
1528600053 | Amanda Watts | Physician Assistant | 135 Rutledge Ave. Msc 561, Charleston, SC 29425 | 2019-10-16 |
1851945497 | Kacy Wonder | Dentist | 173 Ashley Avenue Room 453 Msc 507, Charleston, SC 29425 | 2019-08-01 |
1477114569 | Justin Robert Silverman | Surgery | 169 Ashley Avenue, Room 202 Muh, Msc 333, Charleston, SC 29425 | 2019-06-28 |
1740840024 | Tyler Buckley | Surgery | 169 Ashley Ave, Room 202 Main Hospital, Msc333, Charleston, SC 29425 | 2019-06-18 |
1366001760 | Rayphael Sebastian Hardy | Internal Medicine | 169 Ashley Avenue Room 202 Main Hospital Msc333, Charleston, SC 29425 | 2019-06-10 |
1437718889 | Samar Medani | Internal Medicine | Division of Nephrology, Medical Univ of South Carolina, 96 Jonathan Lucas Street, Room 822, Msc 629, Charleston, SC 29425 | 2019-06-10 |
1427617950 | Emily Suzanne Nyers | Internal Medicine | 169 Ashley Ave., Room 202 Main Hospital, Msc 333, Charleston, SC 29425 | 2019-06-09 |
1790343564 | Alan Cowei Peh | Psychiatry & Neurology | 169 Ashley Avenue Rm 202, Main Hospital Msc 333, Charleston, SC 29425 | 2019-06-05 |
Find all providers in zip 29425 |
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 |
---|---|---|---|---|
1487184727 | Hillary Nona Wright | Dentist | 1064 Gardner Rd Ste 110, Charleston, SC 29407-5711 | 2017-06-19 |
1134472426 | Jeffrey J Laro | Dentist | 2090 Charlie Hall Blvd, Suite 100, Charleston, SC 29414-8200 | 2012-10-24 |
1407117385 | Kara Grasso Veeder | Dentist | 173 Ashley Ave Ste 119, Charleston, SC 29425-8908 | 2012-06-06 |
1013288786 | Periodontal Associates LLC | Dentist | 33 Gamecock Ave Ste A, Charleston, SC 29407-3397 | 2012-01-26 |
1508089301 | Christine Marie Cole | Dentist | 520 Stone Creek Dr, Charleston, SC 29414-5051 | 2007-04-10 |
1457476566 | Christopher Jude Caputo | Dentist | 33a Gamecock Ave, Periodontal Associates, Pa, Charleston, SC 29407-3369 | 2007-03-20 |
1669530994 | Joe William Krayer | Dentist | 173 Ashley Bsb 346, Dental Faculty Prac College of Dental Medicine Musc, Charleston, SC 29425 | 2006-12-06 |
1629585880 | Renata Serricchio Leite | Dentist | 29 Bee Street, Charleston, SC 29425-0001 | 2018-01-09 |
1740646769 | Trident Dental Specialty Partners | Dentist | 6335 Dorchester Rd, Charleston, SC 29418-5103 | 2016-01-06 |
1114332921 | Zachary P Evans | Dentist | 1064 Gardner Rd, Suite #110, Charleston, SC 29407-5768 | 2014-07-01 |
Find all providers in CHARLESTON |
City | CHARLESTON |
Zip Code | 29425 |
Please comment or provide details below to improve the information on DR. MARK LANE MCENTIRE.
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.