CRESTON DENTAL-1, P.C. (NPI# 1972687903) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1972687903 |
Entity Type | Organization |
Organization Name | CRESTON DENTAL-1, P.C. |
Other Organization Name | KOOL SMILES SC, PC |
Practice Address |
3112 N Main St Anderson SC 29621-2763 |
Mailing Address |
1090 Northchase Pkwy Se Ste 150 Marietta GA 30067-6407 |
Practice Telephone | 6789045665 |
Practice Fax Number | 6789045669 |
Mailing Telephone | 7709165036 |
Mailing Fax Number | 6782854760 |
Enumeration Date | 2006-10-25 |
Last Update Date | 2019-05-13 |
Authorized Official Name | DR. TU TRAN (PRESIDENT) |
Authorized Official Telephone | 7709169000 |
Authorized Official Credential | DDS |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 1223E0200X |
Dentist Specialization: Endodontics |
Dental Providers | ||
N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
Dental Providers | ||
Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
Other Name | Type Code |
---|---|
Kool Smiles SC, PC | Former Legal Business Name - Organization |
Street Address |
3112 N MAIN ST |
City | ANDERSON |
State | SC |
Zip Code | 29621-2763 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891189239 | Diane Piccioni | Dentist | 3112 N Main St, Anderson, SC 29621-2763 | 2015-03-24 |
1376855676 | Eric M. Vieth | Dentist | 3112 N Main St, Anderson, SC 29621-2763 | 2010-07-02 |
1215165873 | Martha Clark Hendrix | Dentist | 3112 N Main St, Anderson, SC 29621-2763 | 2009-06-22 |
1053547166 | Robert Todd Tipton | Dentist | 3112 N Main St, Anderson, SC 29621-2763 | 2009-06-03 |
1790907756 | Richard A Moore | Dentist | 3112 N Main St, Anderson, SC 29621-2763 | 2007-05-02 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114574241 | Kathryn L Harwick | Social Worker | 3030 Sc-81, Anderson, SC 29621 | 2019-08-22 |
1326517194 | Ashlea Bronwen Bates | Nurse Practitioner | 3424 Clemson Blvd., Anderson, SC 29621 | 2018-11-21 |
1770051708 | Bailee Vernon Mccarley | Nurse Practitioner | 800 Fant St, Anderson, SC 29621 | 2018-11-07 |
1790278893 | Morgan Cutts | Speech-Language Pathologist | 126 Broadbent Way, Suite A, Anderson, SC 29621 | 2018-06-13 |
1427546233 | Amanda Coker Burnette | Family Medicine | 3000 East Greenville Street, Suite 3700, Anderson, SC 29621 | 2018-04-26 |
1205342169 | Robert Allen Dameron Jr. | Orthopaedic Surgery | 130 Longview Drive, Anderson, SC 29621 | 2017-12-14 |
1578085411 | Michael Jason Bell | Contractor | 520 Hwy 29 Bypass N, Anderson, SC 29621 | 2017-07-12 |
1639629983 | Todd E. Hamilton | Dentist | 1112 Cornelia Road, Anderson, SC 29621 | 2016-10-11 |
1760939110 | Crystal Vaughn | Nurse Practitioner | Sac Anmed Health 2000 East Greenville Street, Anderson, SC 29621 | 2016-09-01 |
1992151328 | Veronica Williams | Non-emergency Medical Transport (VAN) | 2314 Old Williamston Road, Anderson, SC 29621 | 2016-05-04 |
Find all providers in zip 29621 |
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 |
---|---|---|---|---|
1619455417 | Eh Dental, LLC | Dentist | 303 E Highland Ave Ste 105, Anderson, SC 29621-4767 | 2018-08-02 |
1477964112 | Dental Professionals of Sc, PC | Dentist | 3500 Clemson Blvd, Anderson, SC 29621-1313 | 2014-05-15 |
1427484286 | Hopewell Family Dentistry | Dentist | 3728 N. Hwy. 81, Anderson, SC 29621 | 2013-09-24 |
1134472699 | Beemer Dentistry, Pa | Dentist | 1512 N Fant St, Anderson, SC 29621-4708 | 2012-10-22 |
1235490640 | Jennifer Lynn Raymond | Dentist | 2126 Hwy 81 North, Anderson, SC 29621-1532 | 2012-06-01 |
1932410115 | John Michael Waters | Dentist | 512 Reed Rd, Anderson, SC 29621-2058 | 2010-06-23 |
1649403197 | Roscoe Sidney Eatherly | Dentist | 508 W Highway 76, Anderson, MO 64831-8548 | 2009-09-01 |
1255560108 | Mowlajlo Family and Cosmetic Dentistry,llc | Dentist | 205 E Highland Ave # Avw, Anderson, SC 29621-4711 | 2009-07-13 |
1881821064 | William Martin Reuss Iv | Dentist | 1930 North Barney St., Anderson, CA 96007 | 2009-06-16 |
1972739910 | Gabrielle Ferguson Cannick | Dentist | 3905 Liberty Hwy, Anderson, SC 29621-1229 | 2009-06-04 |
Find all providers in ANDERSON |
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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.