Carolina Avenue Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

SC3281 Issued in SC

Legal business name

CAROLINA AVENUE DENTAL

Practice address

214 Carolina Avenue
Moncks Corner, SC 29461

Phone

(843) 899-5911

Fax

(843) 899-5961

NPI assigned

Sep 21, 2006

Organization subpart

No

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

Authorized official

Name

Gloria B Pipkin, DMD

Title

President

Phone

(843) 899-5911

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Anna Tyson Fuller, D.M.D.

  • General Practice Dentistry
  • Columbia, SC
  • NPI 1417152190
  NPD (past)

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023116019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 CAROLINA AVENUE",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "29461",
            "telephone_number": "843-899-5911",
            "fax_number": "843-899-5968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 CAROLINA AVENUE",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "29461",
            "telephone_number": "843-899-5911",
            "fax_number": "843-899-5961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA AVENUE DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PIPKIN",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-899-5911",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "SC3281",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Z32812",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "567546",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christine Canivan, MD
• Anna Elizabeth Cardenas
• Melissa Jean Cardwell, APRN
• Carnes Crossroads Dental Arts P.a.
• Carnes Crossroads Dental P.a
• Carolina Eyecare Physicians LLC
• Mary W Carruthers, MD
• Parvati Case
• Leah Brianne Cassella, R.D., L.D.N.
• Rebecca J Cavazos Morrow, M.S.

• General Practice Dentistry in Moncks Corner, SC
• Providers in Moncks Corner, SC by specialty
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.