OrganizationActive
Lake Wylie Pediatric Dentistry, LLC
NPI 1528428091 · Pediatric Dentistry · Clover, SC
Lake Wylie Pediatric Dentistry, LLC is a Pediatric Dentistry organization in Clover, SC (NPI 1528428091).
Provider details
- NPI number
- 1528428091
- Entity type
- Organization
- Primary specialty
- Pediatric DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Ryan Colosi, Member(803) 619-5155
- License
- 8097 (SC)
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(72/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
534 Nautical Dr.
Clover, SC 29710-6102
Phone: (803) 619-5155
Street-level locationGet directions
Mailing address
534 Nautical Dr
Lake Wylie, SC 29710-5001
Other names (DBA / former)
- Other name
- Ryan P Colosi DDS
Registry dates
- Enumerated
- 2016-02-26
- Last updated
- 2017-03-24
Frequently asked questions
- What is Lake Wylie Pediatric Dentistry, LLC's NPI number?
- Lake Wylie Pediatric Dentistry, LLC's National Provider Identifier (NPI) is 1528428091, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Lake Wylie Pediatric Dentistry, LLC?
- Lake Wylie Pediatric Dentistry, LLC is classified in the NPPES registry as Pediatric Dentistry (Dental Providers).
- Where is Lake Wylie Pediatric Dentistry, LLC located?
- Lake Wylie Pediatric Dentistry, LLC's practice location on file with NPPES is 534 Nautical Dr., Clover, SC 29710-6102.
- What is Lake Wylie Pediatric Dentistry, LLC's phone number?
- The practice phone number listed in the NPPES registry for Lake Wylie Pediatric Dentistry, LLC is (803) 619-5155.
- Who is the authorized official for Lake Wylie Pediatric Dentistry, LLC?
- The authorized official listed on Lake Wylie Pediatric Dentistry, LLC's NPPES record is Ryan Colosi, Member. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Lake Wylie Pediatric Dentistry, LLC's NPI active?
- Yes — Lake Wylie Pediatric Dentistry, LLC's NPI (1528428091) is active in the NPPES registry as of the last update on 2017-03-24.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.