Healthcare Provider Details

I. General information

NPI: 1669399689
Provider Name (Legal Business Name): LAKINTA SMITH HIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5426 FOREST DR
COLUMBIA SC
29206-5401
US

IV. Provider business mailing address

5426 FOREST DR
COLUMBIA SC
29206-5401
US

V. Phone/Fax

Practice location:
  • Phone: 803-787-0204
  • Fax:
Mailing address:
  • Phone: 803-787-0204
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHAS-0791
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: