NORTHEAST ORAL & MAXILLOFACIAL SURGERY CENTER (NPI# 1700916822) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700916822 |
| Entity Type | Organization |
| Organization Name | NORTHEAST ORAL & MAXILLOFACIAL SURGERY CENTER |
| Practice Address |
9310 Two Notch Rd Columbia SC 29223-6416 |
| Practice Telephone | 8036995900 |
| Practice Fax Number | 8037889036 |
| Mailing Telephone | 8036995900 |
| Mailing Fax Number | 8037889036 |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. EVELYN NITKA (OFFICE MANAGER) |
| Authorized Official Telephone | 8036995900 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0106X |
Dentist Specialization: Oral and Maxillofacial Pathology |
3160 | SC | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | ZA9919 | 05 |
| Street Address |
9310 TWO NOTCH RD |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29223-6416 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700848827 | Stephen Edward Clary | Dentist | 9310 Two Notch Rd, Northeast Oral Surgery, Columbia, SC 29223-6416 | 2006-04-04 |
| 1598103277 | Matthew Charles Nimmich | Dentist | 9310 Two Notch Rd, Columbia, SC 29223-6416 | 2013-06-04 |
| 1336382043 | Adam D Hairr | Dentist | 9310 Two Notch Rd, Columbia, SC 29223-6416 | 2009-04-10 |
| 1114985025 | Jeffrey Dootson | Dentist | 9310 Two Notch Rd, Columbia, SC 29223 | 2006-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619522794 | Timothy Drew Edwards | Dentist | 122 N. Brickyard Rd, Columbia, SC 29223 | 2019-08-06 |
| 1861983249 | Southern Pain Specialists | Physical Medicine & Rehabilitation | 115 Blarney Dr Ste 111, Columbia, SC 29223 | 2018-05-22 |
| 1710481452 | Evans Counseling and Consulting, LLC | Social Worker | 120 Wildewood Park Dr Ste A, Columbia, SC 29223 | 2018-03-19 |
| 1750824819 | Marquita Heyward | Counselor | 1 Winsor Cove Suite 303, Columbia, SC 29223 | 2016-11-22 |
| 1578015509 | Carolina Family Pharmacy, LLC | Pharmacy | 9153 Two Notch Road, Columbia, SC 29223 | 2016-10-25 |
| 1225485170 | Lisa Diaz | Occupational Therapy Assistant | 7601 Parlane Rd, Columbia, SC 29223 | 2016-05-20 |
| 1295199859 | Sarah Ann Riley | Nurse Practitioner | Cvs Pharmacy 121 Clemson Rd., Columbia, SC 29223 | 2016-04-11 |
| 1134583214 | Sara Alisha Pound | Behavioral Analyst | 97b Winterberry Ln, Columbia, SC 29223 | 2016-04-05 |
| 1508227653 | Lucy Elvira Vicioso-harris | Counselor | 1310 Oakcrest Dr Apt 318, Columbia, SC 29223 | 2016-03-17 |
| 1134585243 | Robin Heaton | Occupational Therapy Assistant | 7601 Parklane Road, Columbia, SC 29223 | 2016-01-05 |
| Find all providers in zip 29223 | ||||
| Taxonomy Code | 1223P0106X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Pathology |
| The specialty of dentistry and discipline of pathology that deals with the nature, identification, and management of diseases affecting the oral and maxillofacial regions. It is a science that investigates the causes, processes, and effects of these diseases. The practice of oral and maxillofacial pathology includes research and diagnosis of diseases using clinical, radiographic, microscopic, biochemical, or other examinations. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407067473 | Northeast Oral & Maxillofacial | Dentist | 1118 Greenlawn Dr, Columbia, SC 29209-2606 | 2007-05-24 |
| 1003929449 | James W Andrews | Dentist | 1000 W Nifong Blvd, Bldg 4 Ste 100, Columbia, MO 65203-5661 | 2006-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174656540 | River Falls Oral Surgery | Dentist | 700 Squires Pt, Duncan, SC 29334-8879 | 2007-03-14 |
| 1871606830 | Jonathan M Lafond | Dentist | 455 Old Trolley Rd, Ste E, Summerville, SC 29485-5669 | 2006-08-16 |
| 1982622585 | Derek T Dunlap | Dentist | 700 Squire's Pointe Drive, Suite A, Duncan, SC 29334 | 2006-07-18 |
| 1831156777 | Larry Wayne Cobb | Dentist | 2c Cleveland Ct, Greenville, SC 29607-2414 | 2006-04-26 |
| 1912969502 | Theresa Sullivan Gonzales | Dentist | 173 Ashley Avenue Msc 507, Charleston, SC 29401 | 2006-04-06 |
| 1891774162 | Thomas Herbert Simpson Jr. | Dentist | 372 S Herlong Ave, Rock Hill, SC 29732 | 2006-01-13 |
| 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 |
| 1396904405 | Christel Maria Haberland | Dentist | 171 Ashley Ave, Charleston, SC 29425-4804 | 2008-06-03 |
| 1518177807 | Orangeburg Oral Surgery & Implant Center | Dentist | 1175 Cook Rd, Ste 135, Orangeburg, SC 29118-8201 | 2007-05-23 |
| 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.