PAWLEYS ISLAND PEDIATRIC DENTISTRY NPI 1366580276

NPI Information

NPI: 1366580276
Provider Name: PAWLEYS ISLAND PEDIATRIC DENTISTRY
Classification: Dentist - 1223P0221X
Entity Type: Organization

Specialization: Pediatric Dentistry

CLIA Number: 42D2217630

Address:
9462 OCEAN HIGHWAY
PAWLEYS ISLAND, SC
ZIP 29585
Phone: (843) 235-0536
Get Directions

PAWLEYS ISLAND PEDIATRIC DENTISTRY is a pediatric dentistry dentist in Pawleys Island, 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. PAWLEYS ISLAND PEDIATRIC DENTISTRY NPI is 1366580276. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

9462 OCEAN HIGHWAY
PAWLEYS ISLAND, SC
ZIP 29585
Phone: (843) 235-0536
Fax: (843) 237-8459

The provider's authorized official is Meredith Lucius Papadea .
The authorized official title is President and has the following contact phone number (843) 235-0536.

The CLIA number assigned to this NPI record is 42D2217630 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/2/2007 and was last updated on 8/22/2020.

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	3910	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	Other Provider Identifier Issuer
1	ZA9537	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: 11/14/2023

NPI Synchronization or Removal

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