Provider Demographics
NPI:1346489564
Name:VALERIE L. YANISZEWSKI, DMD, PC
Entity Type:Organization
Organization Name:VALERIE L. YANISZEWSKI, DMD, PC
Other - Org Name:SMILES IN THE SUN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:LAUREN
Authorized Official - Last Name:YANISZEWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:803-984-0682
Mailing Address - Street 1:855 HARVEST POINTE DR
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29708-7707
Mailing Address - Country:US
Mailing Address - Phone:803-984-0682
Mailing Address - Fax:
Practice Address - Street 1:6237 CAROLINA COMMONS DR
Practice Address - Street 2:SUITE 301
Practice Address - City:INDIAN LAND
Practice Address - State:SC
Practice Address - Zip Code:29707-6014
Practice Address - Country:US
Practice Address - Phone:803-547-9786
Practice Address - Fax:803-547-6777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-11
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC39831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty