MEDICARE: DR. IVELINA NEDELCHEVA DEAN D.M.D.

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	1223P0300X	Periodontics	988	SC

General Provider Information

NPI Number	:	1912125550
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. IVELINA NEDELCHEVA DEAN D.M.D.

Provider Business Mailing Address
First Line	:	261 HELTON LN
Second Line	:
City	:	FORT MILL
State	:	SC
Zip	:	29708-0075
Country	:	US
Telephone Number	:	803-207-4266
Fax Number	:

Provider Business Practice Location Address
First Line	:	1741 GOLD HILL RD STE 2010
Second Line	:
City	:	FORT MILL
State	:	SC
Zip	:	29708-8205
Country	:	US
Telephone Number	:	803-548-3342
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/20/2007
Last Update Date	:	02/26/2024

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