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LAKE WYLIE MODERN DENTISTRY
NPI 1194376491
Dentist in Lake Wylie, SC

Active since September 27, 2019
140 HIGHWAY 274, LAKE WYLIE, SC 29710(803) 752-0565 Get Directions Write a Review

NPPES record last updated: June 14, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jan 8, 2020, Sep 27, 2019 (2 updates tracked since 2019).

About Lake Wylie Modern Dentistry NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAKE WYLIE MODERN DENTISTRY (NPI 1194376491) is a healthcare organization registered as a dentist in Lake Wylie, South Carolina and active in the NPI registry since September 2019. The organization lists Ali Shahrestani, Owner, as its authorized official.

NPPES Registry Identity

NPI1194376491
Entity TypeOrganization
Primary Taxonomy122300000X
Legal Business NameLAKE WYLIE MODERN DENTISTRY, PC
Location Address140 HIGHWAY 274Lake Wylie, SC 29710-6045
Mailing AddressPo Box 920050Dallas, TX 75392-0050
Phone(803) 752-0565
Organization SubpartNo
Authorized OfficialAli ShahrestaniOwner · (803) 752-0565
Enumeration DateSeptember 27, 2019
Last NPPES UpdateJune 14, 20222 updates tracked since enumeration
NPPES CertifiedJune 14, 2022
✔ NPI 1194376491 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
140 HIGHWAY 274, Lake Wylie, SC 29710
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Other Names 1

Doing Business AsLake Wylie Modern Dentistry

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, BlueCross BlueShield of South Carolina.Insurance ›

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HUSSAM AHMED D.M.D, M.S.
Dentist (Endodontics)
140 HIGHWAY 274
CLOVER, SC 29710
York County (803) 752-0565
ALAN DZHABIEV
Dentist (General Practice)
140 HIGHWAY 274
CLOVER, SC 29710
York County (803) 752-0565
SNEHA PATEL DDS
Dentist
140 HIGHWAY 274
CLOVER, SC 29710
York County (732) 816-0707
SNEHA SURESH BABU
Dentist (General Practice)
140 HIGHWAY 274
CLOVER, SC 29710
York County (803) 752-0565

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lake Wylie Modern Dentistry, PC's NPI number?

The NPI number for Lake Wylie Modern Dentistry, PC is 1194376491. It was assigned to this organization in the NPPES registry on September 27, 2019. The provider is doing business as Lake Wylie Modern Dentistry.

Where is Lake Wylie Modern Dentistry, PC located?

Lake Wylie Modern Dentistry, PC is located at 140 Highway 274, Lake Wylie, SC 29710. The listed phone number is (803) 752-0565.

What is Lake Wylie Modern Dentistry, PC's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

What insurance does Lake Wylie Modern Dentistry, PC accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina and BlueCross BlueShield of South Carolina list Lake Wylie Modern Dentistry, PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lake Wylie Modern Dentistry, PC was last updated on June 14, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.