Healthcare Provider Details

I. General information

NPI: 1134057375
Provider Name (Legal Business Name): ALENA MAE GRAVES DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1033 ROBERTS BRANCH PKWY STE 103
COLUMBIA SC
29203-9148
US

IV. Provider business mailing address

3215 TRADE STREET
WEST COLUMBIA SC
29169
US

V. Phone/Fax

Practice location:
  • Phone: 803-339-8542
  • Fax:
Mailing address:
  • Phone: 269-967-0428
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number11473
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: