Teresa Perez Cavnaugh, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

7119 Issued in SC

Practice address

1028 Edgewater Corporate Pkwy
Indian Land, SC 29707-0107

Phone

(803) 835-2500

NPI assigned

Mar 2, 2007

Last updated

Jan 27, 2025By 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 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1760510499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1604 CHURCHILL DOWNS DR",
            "city": "WAXHAW",
            "state": "NC",
            "postal_code": "28173",
            "telephone_number": "630-391-1026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1028 EDGEWATER CORPORATE PKWY",
            "city": "INDIAN LAND",
            "state": "SC",
            "postal_code": "297070107",
            "telephone_number": "803-835-2500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1604 Churchill Downs Dr",
            "address_purpose": "LOCATION",
            "city": "Waxhaw",
            "state": "NC",
            "postal_code": "28173",
            "country_code": "US",
            "telephone_number": "630-391-1026",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEREZ CAVNAUGH",
        "first_name": "TERESA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-02",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "7119",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.025077",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "10444",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9182559",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• 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 Jan 27, 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.