RAVENEL PERIODONTICS PA NPI 1013569771

NPI Information

  • NPI: 1013569771
  • Provider Name: RAVENEL PERIODONTICS, PA
  • Classification: Dentist - 1223P0300X
  • Specialization: Periodontics
  • Entity Type: Organization
  • Address: 1130 E BUTLER RD
    GREENVILLE, SC
    ZIP 29607
  • Phone: (864) 626-4777

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NPI Details

RAVENEL PERIODONTICS, PA is a periodontics dentist in Greenville, SC. The provider is 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. RAVENEL PERIODONTICS, PA NPI is 1013569771. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1130 E BUTLER RD
GREENVILLE, SC
ZIP 29607-908
Phone: (864) 626-4777
Fax: (864) 626-4779

The provider's authorized official is Lisa Sherwood Ravenel .
The authorized official title is Owner/dentist and has the following contact phone number (864) 626-4777.

The enumeration date for this NPI number is 7/12/2019 and was last updated on 7/12/2019.

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
11223P0300XDentistPeriodonticsYes

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: 11/21/2025

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