Provider Demographics
NPI:1225590961
Name:HYVARINEN JONES, NINA (DDS)
Entity Type:Individual
Prefix:DR
First Name:NINA
Middle Name:
Last Name:HYVARINEN JONES
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:NINA
Other - Middle Name:
Other - Last Name:HYVARINEN JONES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:3201 AMHERST AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29205-1805
Mailing Address - Country:US
Mailing Address - Phone:561-685-4407
Mailing Address - Fax:
Practice Address - Street 1:745 UNIVERSITY VILLAGE DR
Practice Address - Street 2:
Practice Address - City:BLYTHEWOOD
Practice Address - State:SC
Practice Address - Zip Code:29016-7613
Practice Address - Country:US
Practice Address - Phone:803-754-9160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-02
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC95021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCZX9503Medicaid