| Richmond Smiles Youth Dentistry, Llc | |
|
5322 Chamberlayne Ave Richmond VA 23227-2203 | |
| (804) 266-5040 | |
| (804) 266-5030 |
| Full Name | Richmond Smiles Youth Dentistry, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 5322 Chamberlayne Ave, Richmond, Virginia |
| Authorized Official Name and Position | Jenell Stump (MANAGER, LICENSING & CREDENTIALING) |
| Authorized Official Contact | 6157500343 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Richmond Smiles Youth Dentistry, Llc 16 Arcade Unit 198747 Nashville TN 37219-1994 Ph: (615) 750-0343 | Richmond Smiles Youth Dentistry, Llc 5322 Chamberlayne Ave Richmond VA 23227-2203 Ph: (804) 266-5040 |
| NPI Number | 1073582235 |
|---|---|
| Provider Enumeration Date | 03/17/2006 |
| Last Update Date | 07/09/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073582235 | NPI | - | NPPES |
| 1073582235 | Medicaid | VA | |
| 1073582235 | Medicaid | MD | |
| 069745400 | Medicaid | DC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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