Jewel Sparkle Ann Pompey, DMD

Individual provider Active NPI General Practice Dentistry · Ridge Spring, SC

NPI 1861622243 · NPPES record last updated Jul 21, 2009

Key facts

NPI
1861622243
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
4647 (SC)
Practice address
634 E Main St
Ridge Spring, SC 29129-9139
Phone
(803) 685-5555
NPI assigned
Jul 21, 2009
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
4647SCMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr D G Taylor PC General Practice Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4647 SC Yes

Addresses

Primary practice location

634 E Main St
Ridge Spring, SC 29129-9139

Mailing address

PO Box 277
Ridge Spring, SC 29129-0277
Phone (803) 685-5555

Other providers in Ridge Spring, SC

All providers in Ridge Spring, SC · General Practice Dentistry in South Carolina

Sources for this page

Verify at the official NPI Registry.