DR. EDWARD MCCRAY WISE JR. DMD
NPI 1639153430
Dentist - Oral and Maxillofacial Surgery in West Columbia, SC

Active since December 05, 2005Opted out of Medicare · through Apr 11, 2027
112 SALUDA RIDGE CT STE 400, WEST COLUMBIA, SC 29169(803) 796-5791(803) 796-6486 Get Directions Write a Review

NPPES record last updated: March 26, 2018. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Dr. Edward Mccray Wise Jr. Dmd NPPES

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

DR. EDWARD MCCRAY WISE JR. DMD (NPI 1639153430) is an individual oral and maxillofacial surgery provider in West Columbia, South Carolina, licensed in South Carolina (4120) and active in the NPI registry since December 2005. He has opted out of Medicare through April 11, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1639153430
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameDR. EDWARD MCCRAY WISE JR.Credential: DMD
Location Address112 SALUDA RIDGE CT STE 400West Columbia, SC 29169-3461
Mailing Address112 Saluda Ridge Ct Ste 400West Columbia, SC 29169-3461 · (803) 796-5791 · Fax (803) 796-6486
Fax(803) 796-6486
Sole ProprietorYes
Enumeration DateDecember 5, 2005
Last NPPES UpdateMarch 26, 2018
NPI 1639153430 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License Licensed in SC · 4120
Definition

An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

Also ListedDentistTaxonomy 122300000X · License 4120 (SC)
112 SALUDA RIDGE CT STE 400, West Columbia, SC 29169

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Dr. Edward Mccray Wise Jr. Dmd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 11, 2023 through April 11, 2027.

Opt-Out Effective DateApril 11, 2023
Opt-Out In Effect ThroughApril 11, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29169 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.18 typical visit price
range $53.57 – $163.84
Typical copayment $20.79 (range $13.39 – $40.96)
Most-billed visit code 99203
Established Patient
$67.12 typical visit price
range $16.96 – $133.52
Typical copayment $16.78 (range $4.24 – $33.38)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

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

Dentist (Oral and Maxillofacial Surgery)
112 SALUDA RIDGE CT STE 400
WEST COLUMBIA, SC 29169

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1639153430, enumerated as an "individual" on December 05, 2005.

The provider is located at 112 SALUDA RIDGE CT STE 400 WEST COLUMBIA, SC 29169 and the phone number is (803) 796-5791.

Dentist with taxonomy code 1223S0112X and a focus in Oral and Maxillofacial Surgery.

The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, BEST Life, Blue. Please consult your insurance carrier or call the provider to verify.