Provider Demographics
NPI:1033346713
Name:COVINGTON, LUCIA PINCKNEY (DMD)
Entity Type:Individual
Prefix:
First Name:LUCIA
Middle Name:PINCKNEY
Last Name:COVINGTON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:LUCIA
Other - Middle Name:PINCKNEY
Other - Last Name:RAWLINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:637 BELLAMY AVE
Mailing Address - Street 2:UNIT B
Mailing Address - City:MURRELLS INLET
Mailing Address - State:SC
Mailing Address - Zip Code:29576
Mailing Address - Country:US
Mailing Address - Phone:843-947-0017
Mailing Address - Fax:843-947-0668
Practice Address - Street 1:637 BELLAMY AVE
Practice Address - Street 2:UNIT B
Practice Address - City:MURRELLS INLET
Practice Address - State:SC
Practice Address - Zip Code:29576
Practice Address - Country:US
Practice Address - Phone:843-947-0017
Practice Address - Fax:843-947-0668
Is Sole Proprietor?:No
Enumeration Date:2009-06-19
Last Update Date:2016-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC45961223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCZX4596Medicaid