DR. LISA S RAVENEL (NPI# 1891703419) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891703419 |
| Entity Type | Individual |
| Full Name | DR. LISA S RAVENEL |
| Other Name | DR. BRYAN E GREEN |
| Credential | DMD, MHS |
| Practice Address |
1130 E Butler Rd Greenville SC 29607-5908 |
| Practice Telephone | 8649879700 |
| Mailing Telephone | 8649879700 |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
3710 | SC | Dental Providers |
| Street Address |
1130 E BUTLER RD |
| City | GREENVILLE |
| State | SC |
| Zip Code | 29607-5908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013569771 | Ravenel Periodontics, Pa | Dentist | 1130 E Butler Rd, Greenville, SC 29607-5908 | 2019-07-12 |
| 1962932210 | Holley Endodontics, Pa | Clinic/Center | 1130 E Butler Rd, Greenville, SC 29607-5908 | 2017-06-19 |
| 1588105829 | Periodontics of Greenville | Dentist | 1130 E Butler Rd, Greenville, SC 29607-5908 | 2017-03-20 |
| 1508170846 | William F Bohlen | Dentist | 1130 E Butler Rd, Greenville, SC 29607-5908 | 2010-07-28 |
| 1124332465 | Palmetto Periodontics of Greenville Pa | Dentist | 1130 E Butler Rd, Greenville, SC 29607-5908 | 2010-07-28 |
| 1992842868 | Ravenel Endodontics | Dentist | 1130 E Butler Rd, Greenville, SC 29607-5908 | 2007-01-31 |
| 1316084197 | Palmetto Periodontics Pa | Dentist | 1130 E Butler Rd, Greenville, SC 29607-5908 | 2007-01-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245846138 | Personalized Home Care Services | Technician | 1200 Woodruff Rd A3 Ste 150, Greenville, SC 29607 | 2020-09-16 |
| 1396361960 | Complete Homecare of America, Inc. | In Home Supportive Care | 128 Millport Circle, Suite 200, Greenville, SC 29607 | 2020-06-19 |
| 1275175093 | Carrie Laxton Ballenger | Nurse Practitioner | 2094 Woodruff Road, Greenville, SC 29607 | 2019-10-14 |
| 1861047037 | Susannah Long | Marriage & Family Therapist | 109 Laurens Road, Building 4 Ste D, Greenville, SC 29607 | 2019-08-05 |
| 1043872369 | Cheryl Craig Rosemond | Case Manager/Care Coordinator | 5 Century Drive, Suite 130, Greenville, SC 29607 | 2019-07-08 |
| 1457916561 | After Hours Chiropractic LLC | Chiropractor | 1200 Woodruff Rd Blg A-3, Simpsonville, SC 29607 | 2019-05-03 |
| 1952865289 | Orthodontic Specialists of Carolina, PC | Dentist | 611 Haywood Road, Greenville, SC 29607 | 2019-01-31 |
| 1124502307 | Martha Irby | Home Health Aide | 2320 E North St Rr 107, Greenville, SC 29607 | 2018-09-24 |
| 1780164541 | Suval Psychiatric Services, Pa | Clinic/Center | 33 Market Point Dr Ste 2023, Greenville, SC 29607 | 2018-08-20 |
| 1083113963 | Caroline Graham | Nurse Practitioner | 850 S Pleasantburg Dr, Greenville, SC 29607 | 2018-02-06 |
| Find all providers in zip 29607 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568084408 | Diane Jenkins Periodontics of Congaree, LLC | Dentist | 600 Congaree Rd, Greenville, SC 29607-3518 | 2020-05-14 |
| 1649725102 | Carolina Periodontics & Dental Implants | Dentist | 112 W Broad St Unit 405, Greenville, SC 29601-2688 | 2016-08-24 |
| 1699844522 | Patrick L Johnson | Dentist | 108 Oakmont Dr, Greenville, NC 27858-5936 | 2006-11-07 |
| 1306929344 | Periodontics of Greenville | Dentist | 1 Charis Dr, Greenville, SC 29615-6615 | 2006-10-23 |
| 1194823633 | Janet Roberts Edwards | Dentist | 517 West Butler Road, Greenville, SC 29607 | 2006-09-20 |
| 1013569771 | Ravenel Periodontics, Pa | Dentist | 1130 E Butler Rd, Greenville, SC 29607-5908 | 2019-07-12 |
| 1588105829 | Periodontics of Greenville | Dentist | 1130 E Butler Rd, Greenville, SC 29607-5908 | 2017-03-20 |
| 1598178030 | Alex Gillone | Dentist | 1851 Macgregor Downs Rd, Greenville, NC 27834-5925 | 2014-06-03 |
| 1811309321 | Acela Alejandra Martinez Luna | Dentist | 1851 Macgregor Downs Rd, Greenville, NC 27834-5925 | 2014-06-02 |
| 1205177797 | Maged Abdelaal | Dentist | 1851 Macgregor Downs Rd, Greenville, NC 27834-5925 | 2013-03-07 |
| Find all providers in GREENVILLE | ||||
| City | GREENVILLE |
| Zip Code | 29607 |
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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.