EDISTO DENTAL ASSOCIATES LLC (NPI# 1871779413) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871779413 |
| Entity Type | Organization |
| Organization Name | EDISTO DENTAL ASSOCIATES LLC |
| Practice Address |
2197 Saint Matthews Rd Orangeburg SC 29118-2038 |
| Mailing Address |
2197 St. Matthew Road Orangeburg SC 29118 |
| Practice Telephone | 8035311601 |
| Mailing Telephone | 8035311601 |
| Enumeration Date | 2008-01-14 |
| Last Update Date | 2008-01-14 |
| Authorized Official Name | DR. CLIFTON JORDAN III (OWNER/DENTIST) |
| Authorized Official Telephone | 8035311601 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
4010 | SC | Dental Providers |
| Street Address |
2197 SAINT MATTHEWS RD |
| City | ORANGEBURG |
| State | SC |
| Zip Code | 29118-2038 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083662415 | Clifton Jordan IIi | Dentist | 2197 Saint Matthews Rd, Orangeburg, SC 29118-2038 | 2006-05-05 |
| 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 |
| 1710442967 | Central Carolina Endodontics Pa | Dentist | 888 Cook Road, Orangeburg, SC 29118 | 2019-02-01 |
| 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 |
| Find all providers in zip 29118 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851752810 | Gamble Dentalsmart PC | Dentist | 403 Stonewall Jackson Blvd, Orangeburg, SC 29115-7282 | 2016-03-17 |
| 1043457799 | Randolph Charles Bryson | Dentist | 1350 Grove Park Dr, Orangeburg, SC 29115-2455 | 2009-01-17 |
| 1285859348 | United Dental Group, LLC | Dentist | 4215 North Rd, Orangeburg, SC 29118-1128 | 2007-04-16 |
| 1497887491 | Michael Everette Salley | Dentist | 924 Bennett St, Orangeburg, SC 29115-4214 | 2007-03-12 |
| 1356491435 | William Eugene Atkinson | Dentist | 1681 Carolina Ave, Orangeburg, SC 29115-4939 | 2007-01-11 |
| 1053472563 | Robert A. Varn | Dentist | 695 Laurel St, Orangeburg, SC 29115-4834 | 2006-12-12 |
| 1043378870 | L Jarrette Burckhalter Iv | Dentist | 1643 Carolina Avenue, Orangeburg, SC 29115 | 2006-12-05 |
| 1932130606 | Dwight Delano Mcmillan Jr. | Dentist | 939 Calhoun Drive, Orangeburg, SC 29115-6763 | 2006-07-05 |
| 1770538209 | John W. Rheney IIi | Dentist | 882 Cook Road, Orangeburg, SC 29118-2126 | 2006-05-23 |
| 1912964354 | Murtuza Ansari | Dentist | 1340 Park St, Orangeburg, SC 29115-4880 | 2006-04-28 |
| Find all providers in ORANGEBURG | ||||
| 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.