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Contact Information

CAROLINA AVENUE DENTAL
214 CAROLINA AVENUE
MONCKS CORNER, SC29461
 Phone: 843-899-5911
 Fax: 843-899-5961
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for CAROLINA AVENUE DENTAL

NPI # 1023116019
LBN Legal business name CAROLINA AVENUE DENTAL
Authorized official GLORIA PIPKIN - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 09/21/2006
Last updated 08/22/2020 - About 6 years ago
Identifiers
SC License # SC3281
SC Medicaid Z32812
SC Other 567546 UNITED CONCORDIA
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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