Richard Joseph Albenesius, DMD

Individual provider Active NPI General Practice Dentistry · Charleston, SC

NPI 1164599940 · NPPES record last updated Nov 10, 2016

Key facts

NPI
1164599940
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
2556 (SC)
Practice address
173 Ashley Ave # Bsb124
Charleston, SC 29425-4826
Phone
(843) 792-2103
NPI assigned
Nov 29, 2006
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2556SCMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2556 SC Yes

Addresses

Primary practice location

173 Ashley Ave # Bsb124
Charleston, SC 29425-4826

Mailing address

173 Ashley Ave # Bsb349
Charleston, SC 29425-4826
Phone (843) 792-2103

Other providers in Charleston, SC

All providers in Charleston, SC · General Practice Dentistry in South Carolina

Sources for this page

Verify at the official NPI Registry.