Healthcare Provider Details

I. General information

NPI: 1033349550
Provider Name (Legal Business Name): RICARDO MENSAH ABAKAH D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2009
Last Update Date: 05/09/2025
Certification Date: 05/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 NNPTC COMMAND CIRCLE
GOOSE CREEK SC
29445
US

IV. Provider business mailing address

110 NNPTC CIR
GOOSE CREEK SC
29445-6314
US

V. Phone/Fax

Practice location:
  • Phone: 843-794-4502
  • Fax:
Mailing address:
  • Phone: 843-794-7943
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number9044
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number9044
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: