Edna Klatt Depaul, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2529 Issued in SC

Practice address

701 Leader LN
Mt Pleasant, SC 29464-8152

Phone

(843) 345-2307

Fax

(843) 881-3161

NPI assigned

Jun 22, 2005

Last updated

Aug 8, 2013By 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 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Mathis Ferry Dental Associates, Inc.

  • General Practice Dentistry
  • Mount Pleasant, SC
  • NPI 1134245145
  NPD (past) Authorized official

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375920000000",
    "number": "1861498180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 LEADER LN",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294648152",
            "telephone_number": "843-345-2307",
            "fax_number": "843-881-3161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 LEADER LN",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294648152",
            "telephone_number": "843-345-2307",
            "fax_number": "843-881-3161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPAUL",
        "first_name": "EDNA",
        "middle_name": "KLATT",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-22",
        "last_updated": "2013-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "2529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA INS CO",
            "identifier": "488297",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SC DENTAL LICENCE",
            "identifier": "2529",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "992529",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Denslow Family Relations Center, Inc.
• Rebecca Denslow
• Dental Professional of South Carolina, P.C. (Dental Care at Winnowing Way)
• Dental Professionals of South Carolina, P.C. (Dental Care at Mill Creek)
• Dentistry for Children of South Carolina PC
• Dermatopathology Specialists
• Dermatopathology Specialists Jim Phillips MD Dermatopathologist LLC
• Ashley Morgan Desantis, M.A.
• D. Victoria Deshong, LPC, LMFT
• Cary Desmidt, D.C.

• General Practice Dentistry in Mount Pleasant, SC
• Providers in Mount Pleasant, SC by specialty
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2013; 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.