Healthcare Provider Details

I. General information

NPI: 1164081402
Provider Name (Legal Business Name): EMMA JAUCH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMMA HUGHES DMD

II. Dates (important events)

Enumeration Date: 06/11/2019
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7241 BROAD RIVER RD STE 90
IRMO SC
29063-8164
US

IV. Provider business mailing address

7241 BROAD RIVER RD STE 90
IRMO SC
29063-8164
US

V. Phone/Fax

Practice location:
  • Phone: 803-732-3650
  • Fax:
Mailing address:
  • Phone: 803-732-3650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number10676
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN24264
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: