Provider Demographics
NPI:1912015207
Name:TOMPKINS, RICHARD SIMS (DMD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:SIMS
Last Name:TOMPKINS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5250 CLEMSON AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29206-3042
Mailing Address - Country:US
Mailing Address - Phone:803-738-9715
Mailing Address - Fax:803-738-9717
Practice Address - Street 1:5250 CLEMSON AVE
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29206-3042
Practice Address - Country:US
Practice Address - Phone:803-738-9715
Practice Address - Fax:803-738-9717
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC28351223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics