Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
CHARLESTON YOUTH DENTISTRY, LLC
Active
Organization
CHARLESTON YOUTH DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENELL STUMP (MANAGER, LICENSING & CREDENTIALING)
(615) 750-0343
Entity
Organization
Contact information
Practice address
6035A RIVERS AVE, NORTH CHARLESTON, SC 29406-4924
(843) 572-9909
(843) 572-9901
Mailing address
16 ARCADE UNIT 198747, NASHVILLE, TN 37219-1994
(615) 750-0343
(615) 986-1705
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZA9597
—
SC
Enumeration date
05/03/2006
Last updated
07/09/2014
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up