LONGBOARD DENTAL LLC NPI 1134837503

NPI Information

  • NPI: 1134837503
  • Provider Name: LONGBOARD DENTAL LLC
  • Classification: Clinic/Center - 261QD0000X
  • Specialization: Dental
  • Entity Type: Organization
  • Address: 405 FAISON ROAD
    SUIRE A3
    MT PLEASANT, SC
    ZIP 29466
  • Phone: (843) 654-1373

Map and Directions

Get Directions

NPI Details

LONGBOARD DENTAL LLC is a dental clinic center in Mt Pleasant, SC. LONGBOARD DENTAL LLC NPI is 1134837503. The provider is registered as an organization entity type.

The provider's business location address is:

405 FAISON ROAD
SUIRE A3
MT PLEASANT, SC
ZIP 29466
Phone: (843) 654-1373
Fax: (843) 654-1374

The provider's authorized official is Ellen Paulisick Wolf .
The authorized official title is Dentist and has the following contact phone number (843) 654-1373.

The enumeration date for this NPI number is 11/14/2022 and was last updated on 11/14/2022.

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
1261QD0000XClinic/CenterDentalYes

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

NPI Synchronization or Removal

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.

Previous NPI
Next NPI