Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ancient Mariner, LLC

Organization Dental Clinic/Center · NPI 1225456247

Ancient Mariner, LLC is a Dental Clinic/Center in Columbia, South Carolina. Licensed in South Carolina. Registered with an NPI since 2014.

Licensed in
SC
In the registry since
2014
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1118 Greenlawn Dr
Columbia, SC 29209-2606
Phone: (803) 807-2140
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dental Clinic/Center (primary) Taxonomy 261QD0000X · Licence 2905 (SC)

Record details

NPI number1225456247
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tonia Patterson — Office Administrator · (803) 600-7211
Other names Children And Adult Dental Group
NPI enumeratedApril 7, 2014
Last updated in NPPESOctober 27, 2015
Mailing address7457 Patterson Rd Ste 107, Columbia, SC 29209-0710

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