Provider Demographics
NPI:1639259120
Name:KENT, ANYA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANYA
Middle Name:
Last Name:KENT
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 1:1780 GREENSPOINT CT
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29466-8132
Mailing Address - Country:US
Mailing Address - Phone:646-594-3020
Mailing Address - Fax:
Practice Address - Street 1:1780 GREENSPOINT CT
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29466
Practice Address - Country:US
Practice Address - Phone:646-594-3020
Practice Address - Fax:843-352-2430
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0491271223E0200X
SC88271223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics