Provider Demographics
NPI:1013462522
Name:RINEHART DENTISTRY OF PAWLEYS
Entity Type:Organization
Organization Name:RINEHART DENTISTRY OF PAWLEYS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:KENDELL
Authorized Official - Last Name:RINEHART
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:843-545-1295
Mailing Address - Street 1:10185 OCEAN HWY
Mailing Address - Street 2:UNITE B
Mailing Address - City:PAWLEYS ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29585-7402
Mailing Address - Country:US
Mailing Address - Phone:843-314-3935
Mailing Address - Fax:843-314-3938
Practice Address - Street 1:10185 OCEAN HWY
Practice Address - Street 2:UNITE B
Practice Address - City:PAWLEYS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29585-7402
Practice Address - Country:US
Practice Address - Phone:843-314-3935
Practice Address - Fax:843-314-3938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-25
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC69151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCZX6915Medicaid