Ravenel Periodontics, PA

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Legal business name

RAVENEL PERIODONTICS, PA

Practice address

1130 E Butler Rd
Greenville, SC 29607-5908

Phone

(864) 626-4777

Fax

(864) 626-4779

NPI assigned

Jul 12, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Lisa Sherwood Ravenel, DMD

Title

Owner/Dentist

Phone

(864) 626-4777

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1562889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562889600000",
    "number": "1013569771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 938",
            "city": "MAULDIN",
            "state": "SC",
            "postal_code": "296620938",
            "telephone_number": "864-626-4777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 E BUTLER RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296075908",
            "telephone_number": "864-626-4777",
            "fax_number": "864-626-4779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAVENEL PERIODONTICS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-12",
        "last_updated": "2019-07-12",
        "status": "A",
        "authorized_official_last_name": "RAVENEL",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "SHERWOOD",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "864-626-4777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lizzie Calk Ratner, AGACNP
• James G Rau, MD
• Haseeb Ali Rauf, DMD
• Robert Austin Raunikar, M.D.
• Ravenel Endodontics
• Lisa S Ravenel, DMD, MHS
• Trina Nicole Ravenell, PA-C
• Amy Ruth Ravenscraft, NP
• Pinjai Ramadas Ravichander, M.D.
• Senthuran Ravindran, M.D.

• Periodontics in Greenville, SC
• Providers in Greenville, SC by specialty
• Periodontics in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.