Healthcare Provider Details

I. General information

NPI: 1700731239
Provider Name (Legal Business Name): RADHIKA SWAMINATHAN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2026
Last Update Date: 08/23/2026
Certification Date: 08/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

148 SAULS ST STE A
LAKE CITY SC
29560-2677
US

IV. Provider business mailing address

5402 W 134TH TER APT 1212
OVERLAND PARK KS
66209-4281
US

V. Phone/Fax

Practice location:
  • Phone: 843-620-0028
  • Fax:
Mailing address:
  • Phone: 706-421-7850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number11576
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: