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NPI 1972600989

IndividualActive

Gordon Womack, DDS

NPI 1972600989 · Pediatric Dentistry · Hanahan, SC

Provider details

NPI number: 1972600989
Entity type: Individual
Primary specialty: Pediatric DentistryDental Providers
Credential: DDS
Sex: Male
Sole proprietor: Yes
License: DGD.9455GD (SC)

Specialties & taxonomies

Pediatric DentistryPrimary1223P0221XLicense DGD.2025DS (SC)
Dental Providers
Dentist122300000XLicense DGD.9455GD (SC)
Dental Providers
Dentist122300000XLicense 17287 (OH)
Dental Providers
Pediatric Dentistry1223P0221XLicense 17287 (OH)
Dental Providers

Practice location

996 Tanner Ford Blvd

Hanahan, SC 29410-4780

Phone: (843) 212-8810

Approximate (ZIP-level) locationGet directions

More SC providers

Mailing address

102 View St

Moncks Corner, SC 29461-9783

Additional practice locations (1)

3300 Kemp Rd
Beavercreek, OH 45431-4200
Phone: (937) 426-2653
Fax: (937) 426-1124

Registry dates

Enumerated: 2006-09-20
Last updated: 2024-11-19
Certified: 2024-11-19

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

Gordon Womack, DDS — NPI 1972600989, Hanahan, SC | NPI Central