CENTRAL CAROLINA ENDODONTICS PA (NPI# 1710442967) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710442967 |
| Entity Type | Organization |
| Organization Name | CENTRAL CAROLINA ENDODONTICS PA |
| Practice Address |
888 Cook Road Orangeburg SC 29118 |
| Practice Telephone | 8035160777 |
| Practice Fax Number | 8035160577 |
| Mailing Telephone | 8035160777 |
| Mailing Fax Number | 8035160577 |
| Enumeration Date | 2019-02-01 |
| Last Update Date | 2019-02-01 |
| Authorized Official Name | JOSEPH DAVIN BONAVILLA (PRESIDENT) |
| Authorized Official Telephone | 8035160777 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
Dental Providers |
| Street Address |
888 COOK ROAD |
| City | ORANGEBURG |
| State | SC |
| Zip Code | 29118 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386268175 | Sharon Y Tremble | Speech-Language Pathologist | 222 Summit Parkway, Orangeburg, SC 29118 | 2020-06-08 |
| 1922658756 | Orangeburg County School District | Local Education Agency (LEA) | 102 Founders Court, Orangeburg, SC 29118 | 2019-09-13 |
| 1821572009 | Sharon Fogle | Counselor | 2319 Wt. Matthews Road, Orangeburg, SC 29118 | 2018-09-24 |
| 1104320001 | South Carolina Surgical Pa | Surgery | 3045 St Matthews Road, Orangeburg, SC 29118 | 2018-03-23 |
| 1477056794 | Palmetto Moon Anesthesia, LLC | Anesthesiology | 3045 St. Matthews Rd., Orangeburg, SC 29118 | 2018-03-13 |
| 1730691882 | Bio-medical Applications of South Carolina, Inc. | Clinic/Center | 125 Kinard St, Orangeburg, SC 29118 | 2017-10-30 |
| 1154862746 | Latasha Hott | Nurse Practitioner | 2323 St. Matthews Rd, Orangeburg, SC 29118 | 2017-03-15 |
| 1154786960 | R Dale Padgett Md Pa | Clinic/Center | 1727 Villagepark Dr, Orangeburg, SC 29118 | 2015-12-21 |
| 1881977726 | Ontime Transport LLC | Non-emergency Medical Transport (VAN) | 2851 Pelham Ct, Orangeburg, SC 29118 | 2011-09-27 |
| 1710291372 | Tri-county Commission On Alcohol and Drug Abuse | Psychiatric Hospital | 910 Cook Road, Orangeburg, SC 29118 | 2010-08-05 |
| Find all providers in zip 29118 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205045382 | Joseph Davin Bonavilla | Dentist | 888 Cook Rd, Orangeburg, SC 29118-2126 | 2007-05-22 |
| 1083028617 | Melanie Anne Brown | Dentist | 888 Cook Rd, Orangeburg, SC 29118-2126 | 2014-06-11 |
| 1063708410 | Kool Smiles Sc-2, PC | Dentist | 1350 Grove Park Dr, Orangeburg, SC 29115-2455 | 2011-06-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881007946 | Intercoastal Endo, PC | Dentist | 4382 Oleander Dr, Myrtle Beach, SC 29577 | 2014-06-06 |
| 1568775468 | Kool Smiles Sc-2, PC | Dentist | 5422 Forest Dr, Columbia, SC 29206-5412 | 2010-07-20 |
| 1992018899 | Kool Smiles Sc-2, PC | Dentist | 4400 Dorchester Rd Ste 108, Charleston, SC 29405-6863 | 2010-07-20 |
| 1912230335 | Omar James Jones IIi | Dentist | 237 Plantation Dr, Manning, SC 29102-9504 | 2009-09-16 |
| 1972733624 | Robert P Bethea | Dentist | 34 Lakeview Cir, Columbia, SC 29206-3214 | 2009-07-15 |
| 1295975977 | Jason H. Cohen, Dmd, LLC | Dentist | 198 Rutledge Ave Ste 3, Charleston, SC 29403-5834 | 2009-02-20 |
| 1508029554 | Gavin L Criser | Dentist | 220 Cherokee Rd Ste B, Florence, SC 29501-5225 | 2008-07-09 |
| 1912188525 | Michael Eugene Piepenbring | Dentist | 1109 Memorial Ln Ste B, Georgetown, SC 29440-3369 | 2007-11-26 |
| 1962600437 | Michael John Pfister | Dentist | 101 Finley St, Clemson, SC 29631-1583 | 2007-07-06 |
| 1669692349 | Walter R. Long | Dentist | 10 Farmfield Ave Ste E, Charleston, SC 29407-7756 | 2007-04-26 |
| Find all providers with the same taxonomy | ||||
| City | ORANGEBURG |
| Zip Code | 29118 |
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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.