FLEETWOOD SQUARE DENTAL, LLC (NPI# 1831700178) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831700178 |
| Entity Type | Organization |
| Organization Name | FLEETWOOD SQUARE DENTAL, LLC |
| Practice Address |
105 Fleetwood Dr Easley SC 29640-2019 |
| Practice Telephone | 8648552788 |
| Practice Fax Number | 8648552689 |
| Mailing Telephone | 8648552788 |
| Mailing Fax Number | 8648552789 |
| Enumeration Date | 2020-08-11 |
| Last Update Date | 2020-08-11 |
| Authorized Official Name | DR. SONIA KAKKAR (MBR) |
| Authorized Official Telephone | 8648552788 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Street Address |
105 FLEETWOOD DR |
| City | EASLEY |
| State | SC |
| Zip Code | 29640-2019 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215061106 | Willis Ely Hawkins IIi | Dentist | 105 Fleetwood Dr, Easley, SC 29640-2019 | 2007-03-15 |
| 1073647889 | Fleetwood Dental | Dentist | 105 Fleetwood Dr, Easley, SC 29640-2019 | 2007-03-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063935773 | Mary Kathryn Henderson | Speech-Language Pathologist | 1400 Griffin Mill Road, Easley, SC 29640 | 2017-07-25 |
| 1417309451 | Ashby Park Pediatric Dentistry Easley | Dentist | 708 North A Street, Easley, SC 29640 | 2016-07-01 |
| 1548696990 | Phuong T Tran | Pharmacist | 309 Rolling Hills Circle, Easley, SC 29640 | 2013-09-17 |
| 1538593017 | Baptist Easley Hospital | Clinic/Center | 200 Fleet Wood Dr 3 Rd Floor, Easley, SC 29640 | 2013-09-03 |
| 1942507173 | Joanne Mason Wilkinson | Occupational Therapist | 1807a East Main St, Easley, SC 29640 | 2011-02-24 |
| 1861793911 | Ark Pharmacy Services LLC | Pharmacy | 5119- A Calhoun Memorial Hwy, Easley, SC 29640 | 2010-11-05 |
| 1659507952 | Sarah Elizabeth Proulx | Dentist | 227 South Pendleton Street, Suita A, Easley, SC 29640 | 2009-06-02 |
| 1508030503 | Jean Claire Palmour | Massage Therapist | 404 South Fifth Street, Jj & Company Salon & Spa, Easley, SC 29640 | 2008-04-22 |
| 1760685143 | Cannon Memorial Hospital | Family Medicine | 111 W. Roper Rd., Easley, SC 29640 | 2007-06-06 |
| 1942419171 | William Kent Hammond | Dentist | 298 Enterprise Dr, Easley, SC 29640 | 2007-05-22 |
| Find all providers in zip 29640 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861904286 | Crowns Now Easley, LLC | Clinic/Center | 107 Village Ln, Easley, SC 29642-8961 | 2017-10-25 |
| 1942443908 | Dr. John R. White, Dds & Dr. Chris N. Siachos, Dmd | Clinic/Center | 123 E 1st Ave, Easley, SC 29640-3036 | 2009-04-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790386613 | Grinville Dentistry LLC | Clinic/Center | 114 Laurens Rd Ste A, Greenville, SC 29607-1826 | 2020-11-06 |
| 1699380923 | Beaufort Center for Dentistry LLC | Clinic/Center | 1264 Ribaut Rd Ste 401, Beaufort, SC 29902-6129 | 2020-09-14 |
| 1154934354 | Spectrum Integrative Dentistry | Clinic/Center | 2131 Woodruff Rd Ste 1100, Greenville, SC 29607-5934 | 2020-08-26 |
| 1992316053 | Childrens Dentistry of Greenville | Clinic/Center | 410 Pelham Rd Ste A, Greenville, SC 29615-3502 | 2020-08-12 |
| 1457978207 | Dash Dental LLC | Clinic/Center | 310 Business Pkwy Ste D, Greer, SC 29651-7118 | 2020-06-28 |
| 1851916332 | Palmetto Advanced Dentistry | Clinic/Center | 2021 Bridgemill Dr Ste 100, Indian Land, SC 29707-9211 | 2020-06-10 |
| 1326669714 | River Landing Dentistry At Nexton LLC | Clinic/Center | 200 Brighton Park Blvd Ste A, Summerville, SC 29486-3000 | 2020-04-27 |
| 1730715293 | Fort Mill Dobys Bridge Dental LLC | Clinic/Center | 1500 Fort Mill Pkwy #108, Fort Mill, SC 29715 | 2020-03-17 |
| 1215570643 | Pearl Dental Studio | Clinic/Center | 117 Batesville Rd Ste 202, Simpsonville, SC 29681-4815 | 2019-10-17 |
| 1497303770 | Holy City Dentistry LLC | Clinic/Center | 862 Folly Rd Ste 110, Charleston, SC 29412-3452 | 2019-08-29 |
| 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.