NPI 1104372788

Thomas Ryan Shealy, DMD

Practitioner Military Health Care Provider Columbia, SC

Practice location

Address: 4323 Champion Hill St, Columbia, SC 29207-6022
Phone: (803) 751-0677
Mailing address: 4323 Hill St, Fort Jackson, SC 29207

Registered specialties (2)

Military Health Care Provider Primary

Other Service Providers Taxonomy 171000000X Licence 32677 (TX)

Other Military Health Care Provider providers in South Carolina →

Dentist

Dental Providers Taxonomy 122300000X Licence 32677 (TX)

Other Dentist providers in South Carolina →

Registry record

NPI: 1104372788
Entity type: Individual
Sex (as registered): Male
NPI issued: 1 Sep 2016
Record last updated: 7 Oct 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.