Alyssa Gustafson, RDH

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

11961 Issued in SC

Practice address

1099 N Main St Ste 102
Summerville, SC 29483-7300

Phone

(843) 536-8577

NPI assigned

Sep 17, 2021

Last updated

Sep 17, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Summerville Smiles Dental Office, PC

  • General Practice Dentistry
  • Summerville, SC
  • NPI 1972179307
  NPD

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

{
    "created_epoch": "1631836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631836800000",
    "number": "1053081232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3102 POPLAR GROVE PL",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294831697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1099 N MAIN ST STE 102",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294837300",
            "telephone_number": "843-536-8577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTAFSON",
        "first_name": "ALYSSA",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-17",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "SC",
            "license": "11961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashton Guichard, NP
• Jared Guichard
• Wallace Lyndon Guilford III, D.M.D.
• Tory R Guilliam, DPT
• Alexandra Gumen, RDN
• Veronica Guy, DMD
• Jenni Lisa Hackenberg
• Rebecca D Hackett, LPC
• Claudia M Hafer
• Deborah Elizabeth Haffner, DMD

• Dental Hygienist in Summerville, SC
• Providers in Summerville, SC by specialty
• Dental Hygienist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2021; 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.