Provider Demographics
NPI:1750520623
Name:KIDS FIRST DENTAL, LLC
Entity type:Organization
Organization Name:KIDS FIRST DENTAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARIDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-784-2721
Mailing Address - Street 1:655 SAINT ANDREWS RD STE 8
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29210-5136
Mailing Address - Country:US
Mailing Address - Phone:803-805-7232
Mailing Address - Fax:
Practice Address - Street 1:655 SAINT ANDREWS RD STE 8
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29210-5136
Practice Address - Country:US
Practice Address - Phone:803-805-7232
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-16
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3691122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty