Provider Demographics
NPI:1265454789
Name:GOINS, MINDY R (DDS)
Entity Type:Individual
Prefix:DR
First Name:MINDY
Middle Name:R
Last Name:GOINS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1012 N WOODLAND DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:SC
Mailing Address - Zip Code:29720-1966
Mailing Address - Country:US
Mailing Address - Phone:803-285-7645
Mailing Address - Fax:803-285-7687
Practice Address - Street 1:1012 N WOODLAND DR
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:SC
Practice Address - Zip Code:29720-1966
Practice Address - Country:US
Practice Address - Phone:803-285-7645
Practice Address - Fax:803-285-7687
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC34121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCZ34124Medicaid
SC3412OtherDENTAL LICENSE NUMBER
SCBG5310963OtherDEA