MEDICARE: OMNI DENTAL OF LEXINGTON LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1528925864
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OMNI DENTAL OF LEXINGTON LLC

Provider Business Mailing Address
First Line	:	212 OUTLET POINTE BLVD
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29210-5667
Country	:	US
Telephone Number	:	803-667-8559
Fax Number	:

Provider Business Practice Location Address
First Line	:	1283 N LAKE DR
Second Line	:
City	:	LEXINGTON
State	:	SC
Zip	:	29072-7647
Country	:	US
Telephone Number	:	803-667-8559
Fax Number	:

Authorized Official
Title or Position	:	OWNER/DENTIST
Name	:	DR. BRANDON CAIN
Credential	:	DMD
Telephone Number	:	803-851-1280

Provider Enumeration Date	:	01/08/2026
Last Update Date	:	01/08/2026

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