Dental Wellness Center of Manning, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

DENTAL WELLNESS CENTER OF MANNING, LLC

Practice address

1988 Paxille Hwy, Ste 613-01
Manning, SC 29102

Phone

(803) 525-0080

Fax

(912) 226-3489

NPI assigned

Mar 5, 2019

Organization subpart

No

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

Authorized official

Name

Mrs. Christie Lawrence

Title

Corporate Operations Coordinator

Phone

(912) 920-5577

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1551744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1720546138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60339",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314200339",
            "telephone_number": "912-920-5577",
            "fax_number": "912-226-3489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1988 PAXILLE HWY, STE 613-01",
            "city": "MANNING",
            "state": "SC",
            "postal_code": "29102",
            "telephone_number": "803-525-0080",
            "fax_number": "912-226-3489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL WELLNESS CENTER OF MANNING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-05",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE",
        "authorized_official_first_name": "CHRISTIE",
        "authorized_official_title_or_position": "CORPORATE OPERATIONS COORDINATOR",
        "authorized_official_telephone_number": "912-920-5577",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1497918759",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GA LICENSE",
            "identifier": "DN010747",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cypress Family Medicine
• Jagat Chand Daliya, MD
• Amani Davies
• Lakin Leeann Davis, PHARMD
• Dental Wellness Center Eb5 VI LLC
• Angelo Joseph Devivo, OD
• Diamond Medical Supply, LLC
• Lashonda Michelle Dingle, FNP
• Gaye Moore Douglas, FNP
• Cherry A Dow

• Dental Clinic/Center in Manning, SC
• Providers in Manning, SC by specialty
• Dental Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.