IMMEDIATE DENTAL GROUP COLUMBIA (NPI# 1790039212) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790039212 |
| Entity Type | Organization |
| Organization Name | IMMEDIATE DENTAL GROUP COLUMBIA |
| Practice Address |
1118 Greenlawn Drive Columbia SC 29209 |
| Practice Telephone | 8038072140 |
| Practice Fax Number | 8038072141 |
| Mailing Telephone | 8038072140 |
| Mailing Fax Number | 8038072141 |
| Enumeration Date | 2012-11-06 |
| Last Update Date | 2012-11-06 |
| Authorized Official Name | ZACHARY TODD DAUGHERTY (BUSINESS MANAGER) |
| Authorized Official Telephone | 9105263487 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | SC2662 | SC | Dental Providers |
| Street Address |
1118 GREENLAWN DRIVE |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29209 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992293013 | Pertile Group LLC | Family Medicine | 26 Foot Point Rd, Columbia, SC 29209 | 2018-04-24 |
| 1083156061 | Derek Clark | Physical Therapist | 6349 Garners Ferry Rd, Columbia, SC 29209 | 2016-11-08 |
| 1922450345 | Heather Alexander | Social Worker | 6439 Garners-ferry Road, Suite 122, Wjb Dorn Va, Columbia, SC 29209 | 2016-07-09 |
| 1265888325 | Daphne Elaine Allen | Counselor | 1850 Pinview Dr, Columbia, SC 29209 | 2016-05-09 |
| 1659757649 | Marc Edmundson | Pharmacist | 500 Gills Creek Pkwy #810, Columbia, SC 29209 | 2015-08-03 |
| 1477949113 | Winter Years Home Health Care Agency, LLC | Home Health | 1101 1st Street, P, Columbia, SC 29209 | 2015-04-09 |
| 1285045773 | Alireza Adhami | Pharmacist | 7235 Garners Ferry Rd, Columbia, SC 29209 | 2014-05-19 |
| 1275896284 | Tariq Horani | Internal Medicine | 6349 Garners Ferry Road, Int Med -, Columbia, SC 29209 | 2012-06-25 |
| 1902165467 | Medcare Urgent Care Center Garners Ferry, LLC | Clinic/Center | 7418 Garners Ferry Road, Columbia, SC 29209 | 2012-05-03 |
| 1134428923 | Tyrone G Roberson Sr. | Registered Nurse | 6439 Garners Ferry, Columbia, SC 29209 | 2011-03-20 |
| Find all providers in zip 29209 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417558057 | Roberto Selonk Buechele | Dentist | 460 Killian Rd Ste 1, Columbia, SC 29203-9742 | 2020-11-02 |
| 1265043756 | Steven Mariani Rodriguez | Dentist | 5330 Moseby Street, Columbia, SC 29207 | 2020-08-10 |
| 1629688338 | Tennessee Valley Dental Partners, P.C. | Dentist | 1501 Nashville Hwy Ste 102, Columbia, TN 38401-2016 | 2020-08-06 |
| 1912516923 | Richard Houston Rash | Dentist | 303 N Keene St Ste 202-210, Columbia, MO 65201-8050 | 2020-07-26 |
| 1568082493 | Nichole Eckrich | Dentist | 5330 Moseby St., Columbia, SC 29207 | 2020-04-21 |
| 1104304393 | Signature Smiles, LLC | Dentist | 1730 Henderson St Ste A, Columbia, SC 29201-2648 | 2018-07-31 |
| 1255837167 | Ivan Liang Zhang | Dentist | 10910 Little Patuxent Pkwy Ste 103r, Columbia, MD 21044-3081 | 2018-04-01 |
| 1831605401 | Bela Family Dentistry of Sandhills | Dentist | 126 Barton Creek Ct, Columbia, SC 29229-8027 | 2017-12-19 |
| 1588175087 | Palmetto Mobile Dental Centers LLC | Dentist | 1703 Laurel St, Columbia, SC 29201-2660 | 2017-10-24 |
| 1619491461 | Jacquelyn L Wiles | Dentist | 5615 Hood St, Columbia, SC 29207-5109 | 2017-08-02 |
| Find all providers in COLUMBIA | ||||
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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.