Provider Demographics
NPI:1528631140
Name:DUPIM, MONICA SAMPAIO (DMD)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:SAMPAIO
Last Name:DUPIM
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:MONICA
Other - Middle Name:SAMPAIO
Other - Last Name:DUPIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ANDRADE
Mailing Address - Street 1:1236 EBENEZER RD STE 100
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-2300
Mailing Address - Country:US
Mailing Address - Phone:978-935-1016
Mailing Address - Fax:803-328-8149
Practice Address - Street 1:1236 EBENEZER RD STE 100
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-2300
Practice Address - Country:US
Practice Address - Phone:803-328-8148
Practice Address - Fax:803-328-8149
Is Sole Proprietor?:No
Enumeration Date:2021-07-21
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10012122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC10012OtherSOUTH CAROLINA DENTAL BOARD