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TRIDENT DENTAL ASSOCIATES LLC NPI 1053083154


NPI Information

NPI: 1053083154
Provider Name: TRIDENT DENTAL ASSOCIATES, LLC
Classification: Dentist - 1223S0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

Address:
9228 MEDICAL PLAZA DR
CHARLESTON, SC
ZIP 29406
Phone: (843) 574-5693
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TRIDENT DENTAL ASSOCIATES, LLC is an oral and maxillofacial surgery dentist in Charleston, SC. The provider is the specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. TRIDENT DENTAL ASSOCIATES, LLC NPI is 1053083154. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

9228 MEDICAL PLAZA DR
CHARLESTON, SC
ZIP 29406-125
Phone: (843) 574-5693
Fax: (843) 764-4512

The provider's authorized official is William Tederick Johnson .
The authorized official title is Group Vice President/ao and has the following contact phone number (615) 372-3375.

The enumeration date for this NPI number is 9/28/2021 and was last updated on 9/29/2021.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223S0112XDentistOral and Maxillofacial SurgeryYes

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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.