SEASIDE PEDIATRIC DENTAL ASSOCIATES (NPI# 1578084331) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578084331 |
| Entity Type | Organization |
| Organization Name | SEASIDE PEDIATRIC DENTAL ASSOCIATES |
| Practice Address |
4410 Highway 17 Unit B6 Murrells Inlet SC 29576 |
| Mailing Address |
4410 Highway 17 Unit B6 Murrells Inlet SC 29576-6434 |
| Practice Telephone | (423) 741-9078 |
| Mailing Telephone | 4237419078 |
| Enumeration Date | 2017-07-03 |
| Last Update Date | 2018-07-06 |
| Authorized Official Name | DR. MATTHEW TILLMAN (CO-OWNER) |
| Authorized Official Telephone | 8436515437 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers |
| Street Address |
4410 HIGHWAY 17 UNIT B6 |
| City | MURRELLS INLET |
| State | SC |
| Zip Code | 29576 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265697387 | Aaron Forsythe Bloom | Dentist | 4410 Highway 17 Unit B6, Murrells Inlet, SC 29576-6434 | 2008-07-29 |
| 1073809133 | Matthew David Tillman | Dentist | 4410 Highway 17 Unit B6, Murrells Inlet, SC 29576-6434 | 2011-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619577665 | Mobilityworks, LLC | Durable Medical Equipment & Medical Supplies | 11816 Frontage Rd., Murrells Inlet, SC 29576 | 2020-10-29 |
| 1457986267 | Seaside Eye Associates South LLC | Optometrist | 640 Morse Ave, Unit 11, Murrells Inlet, SC 29576 | 2020-03-12 |
| 1710443833 | Sirach Health Professional Limited Liability Company | Physical Medicine & Rehabilitation | 4070 Us Highway 17 Bypass South, Murrells Inlet, SC 29576 | 2019-02-13 |
| 1801350871 | Doctors Care, P.a. | Emergency Medicine | 12015 Highway 707, Murrells Inlet, SC 29576 | 2019-01-24 |
| 1568949154 | Melanie Lewis | Physical Therapist | 2586 Hwy 17 Business S, Murrells Inlet, SC 29576 | 2018-07-26 |
| 1528550035 | Lauren Munck | Family Medicine | Tidelands Waccamaw Community Hospital, 4070 Highway 17, Murrells Inlet, SC 29576 | 2018-05-31 |
| 1003312521 | Myrtle Beach Rehabilitation Hospital, LLC | Rehabilitation Hospital | 4070 Hwy 17 Bypass South, Murrells Inlet, SC 29576 | 2018-04-03 |
| 1467952218 | Jamaica E Alston | Student in an Organized Health Care Education/Training Program | 14 Ambassador Lane, Murrells Inlet, SC 29576 | 2018-02-19 |
| 1891209227 | Caleb Sims Whitney | Physical Medicine & Rehabilitation | 10800 Sc 707, Murrells Inlet, SC 29576 | 2017-11-21 |
| 1043720964 | Chartwell Durable Medical Supply, LLC | Durable Medical Equipment & Medical Supplies | 671 Jamestown Drive, Suite 104, Murrells Inlet, SC 29576 | 2017-10-05 |
| Find all providers in zip 29576 | ||||
| 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 |
|---|---|---|---|---|
| 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 | ||||
| City | MURRELLS INLET |
| Zip Code | 29576 |
Please comment or provide details below to improve the information on SEASIDE PEDIATRIC DENTAL ASSOCIATES.
| 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.