Provider Demographics
NPI:1144020116
Name:EDWARDS, CAROLINE DIANNE (DMD)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:DIANNE
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 BOGARD ST APT B
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29403-5367
Mailing Address - Country:US
Mailing Address - Phone:843-696-5149
Mailing Address - Fax:
Practice Address - Street 1:1257 KILAUEA AVE # 100
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-4205
Practice Address - Country:US
Practice Address - Phone:808-333-3610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program