Provider Demographics
NPI:1578310728
Name:DUNLAP, RANDI (RDH)
Entity type:Individual
Prefix:
First Name:RANDI
Middle Name:
Last Name:DUNLAP
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1329 CHRISMILL LN
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29466-7968
Mailing Address - Country:US
Mailing Address - Phone:843-568-6522
Mailing Address - Fax:
Practice Address - Street 1:1329 CHRISMILL LN
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29466-7968
Practice Address - Country:US
Practice Address - Phone:843-568-6522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2966124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Single Specialty