KIDS TEETH LLC NPI 1053376491

NPI Information

NPI: 1053376491
Provider Name: KIDS TEETH, LLC

Former Legal Business Name: WROBLESKI & MACDONALD PEDIATRIC DENTAL PARTNERSHIP

Classification: Dentist - 1223P0221X
Entity Type: Organization

Specialization: Pediatric Dentistry

Address:
389 JOHNNIE DODDS BLVD
SUITE B
MT PLEASANT, SC
ZIP 29464
Phone: (843) 884-7041
Get Directions

KIDS TEETH, LLC is a pediatric dentistry dentist in Mt Pleasant, SC. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. KIDS TEETH, LLC NPI is 1053376491. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Wrobleski & Macdonald Pediatric Dental Partnership.

The provider's business location address is:

389 JOHNNIE DODDS BLVD
SUITE B
MT PLEASANT, SC
ZIP 29464-950
Phone: (843) 884-7041
Fax: (843) 971-9299

The provider's authorized official is Belinda R Wierschem .
The authorized official title is Office Manager and has the following contact phone number (843) 216-5879.

The enumeration date for this NPI number is 4/19/2006 and was last updated on 1/25/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223P0221X	Dentist	Pediatric Dentistry	3881	SOUTH CAROLINA	No
2	1223P0221X	Dentist	Pediatric Dentistry	3863	SOUTH CAROLINA	No
3	1223X0400X	Dentist	Orthodontics and Dentofacial Orthopedics	3030	SOUTH CAROLINA	No
4	207L00000X	Anesthesiology		7171	SOUTH CAROLINA	No
5	1223P0221X	Dentist	Pediatric Dentistry	2085	SOUTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	ZX3881	MEDICAID	SOUTH CAROLINA
2	Z20850	MEDICAID	SOUTH CAROLINA
3	ZA9866	MEDICAID	SOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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