Theodore D. Ravenel V, DMD
NPI 1013070879ActiveIndividual· Dentist, Endodontics· Augusta, GA
Dentist, Endodontics (DMD) in Augusta, Georgia, licensed in GA and SC, with an NPI issued in December 2006. Enrolled in Medicare as practitioner - endodontics.
Overview
| NPI | 1013070879 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | DMD |
| Sole proprietor | No |
| NPI issued | Dec 19, 2006 |
| Last updated in NPPES | Jul 2, 2024 |
| Certified by provider | Jul 2, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, Endodontics Primary | 1223E0200X | DNF000463 | GA |
| Dentist, Endodontics | 1223E0200X | 3711 | SC |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Endodontics (GA) |
|---|
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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