Ideal Dental Indian Land PC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

IDEAL DENTAL INDIAN LAND PC

Practice address

2089 Parkway Dr Ste 102
Indian Land, SC 29707-8089

Phone

(803) 829-0119

NPI assigned

Feb 13, 2025

Last updated

Feb 13, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Matthew Ddoan, DDS

Title

Owner

Phone

(803) 829-0119

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1739404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739404800000",
    "number": "1629873898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840925",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752840925",
            "telephone_number": "972-361-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2089 PARKWAY DR STE 102",
            "city": "INDIAN LAND",
            "state": "SC",
            "postal_code": "297078089",
            "telephone_number": "803-829-0119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDEAL DENTAL INDIAN LAND PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-13",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A",
        "authorized_official_last_name": "DDOAN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-829-0119",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Staci M Holles-Sobota, DO
• Kayce Marie Hoover, NP-C
• Christina Huber, DDS
• Tiffany Clarissa Huggins, MED,NCC,LPCS,LCMHCS
• Samia Hunter
• Zealkumari Kisansinh Inamdar
• Indian Land Eye Care Center, LLC
• Indian Land Pharmacy (Carolina Pharmacy)
• Instride Foot and Ankle Specialists, PLLC
• Instride Foot and Ankle Specialists, PLLC

• Dentist in Indian Land, SC
• Providers in Indian Land, SC by specialty
• Dentist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2025; 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.