Individual provider Active NPI

Abigail Renee Yoder, DDS

  • General Practice Dentistry
  • Summerville, SC
National Provider Identifier
1790667038
Registry record updated Jul 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
11195 Issued in SC
Practice address
1099 N Main St Ste 102
Summerville, SC 29483-7300
Phone
(843) 536-8577
NPI assigned
Jul 25, 2025
Last updated
Jul 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 11195 SC Primary

Addresses

Primary practice location

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

Mailing address

51243 Leeward PT
Granger, IN 46530-4826
Phone (574) 286-7390

Other practice location 1

2830 US-52 Ste 360, Moncks Corner, SC 29461
Moncks Corner, SC 29461
Phone (843) 990-4715

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11195SCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Summerville Smiles Dental Office, PC General Practice CurrentSince Jul 28, 2025 Accepting new patients
Moncks Corner Dental Group, PC General Practice PastSince Feb 12, 2023 Accepting new patients

Locations

1099 N Main St
#102
Summerville, SC 29483
Phone (843) 536-8577

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1753401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753401600000",
    "number": "1790667038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51243 LEEWARD PT",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465304826",
            "telephone_number": "574-286-7390"
        },
        {
            "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": [
        {
            "address_1": "2830 US-52 Ste 360, Moncks Corner, SC 29461",
            "address_purpose": "LOCATION",
            "city": "Moncks Corner",
            "state": "SC",
            "postal_code": "29461",
            "country_code": "US",
            "telephone_number": "843-990-4715",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YODER",
        "first_name": "ABIGAIL",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-25",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "11195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.