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SAVANNAH SMILES YOUTH DENTISTRY PC NPI 1841265451


NPI Information

NPI: 1841265451
Provider Name: SAVANNAH SMILES YOUTH DENTISTRY, PC
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

CLIA Number: 11D0923204

Address:
2127 E VICTORY DR
SUITE #2
SAVANNAH, GA
ZIP 31404
Phone: (912) 443-6013
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SAVANNAH SMILES YOUTH DENTISTRY, PC is a general practice dentist in Savannah, GA. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. SAVANNAH SMILES YOUTH DENTISTRY, PC NPI is 1841265451. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2127 E VICTORY DR
SUITE #2
SAVANNAH, GA
ZIP 31404-917
Phone: (912) 443-6013
Fax: (912) 443-6014

The provider's authorized official is Jenell Stump .
The authorized official title is Director, Licensing & Credentialing and has the following contact phone number (912) 443-6013.

The CLIA number assigned to this NPI record is 11D0923204 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/18/2006 and was last updated on 3/26/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223G0001XDentistGeneral PracticeYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1401680528AMEDICAIDGEORGIA
21888552OTHERGEORGIAUNITED CONCORDIA
3539121OTHERGEORGIAAVESIS
4ZAG977MEDICAIDSOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.