Richmond Smiles Youth Dentistry, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

RICHMOND SMILES YOUTH DENTISTRY, LLC

Practice address

5322 Chamberlayne Ave
Richmond, VA 23227-2203

Phone

(804) 266-5040

Fax

(804) 266-5030

NPI assigned

Mar 17, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Jenell Stump

Title

Manager, Licensing & Credentialing

Phone

(615) 750-0343

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tyson Walker Anderson

  • General Practice Dentistry
  • Richmond, VA
  • NPI 1881709236
  NPD (past)
• Whitney Elizabeth Maier, DDS

  • Dentist
  • Richmond, VA
  • NPI 1265726657
  NPD (past)
• Ailin Shan

  • General Practice Dentistry
  • Richmond, VA
  • NPI 1568439859
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404864000000",
    "number": "1073582235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 ARCADE UNIT 198747",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372191994",
            "telephone_number": "615-750-0343",
            "fax_number": "615-986-1705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5322 CHAMBERLAYNE AVE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232272203",
            "telephone_number": "804-266-5040",
            "fax_number": "804-266-5030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHMOND SMILES YOUTH DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-17",
        "last_updated": "2014-07-09",
        "status": "A",
        "authorized_official_last_name": "STUMP",
        "authorized_official_first_name": "JENELL",
        "authorized_official_title_or_position": "MANAGER, LICENSING & CREDENTIALING",
        "authorized_official_telephone_number": "615-750-0343",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073582235",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073582235",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "069745400",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Richmond Residential Services, Inc
• Richmond Sexual Health & Wellness, LLC
• Richmond Speech Therapy
• Richmond Sports Massage, LLC
• Richmond Surgical Arts, Inc.
• Richmond Surgical Group Inc
• Richmond Surgical Group Inc

• General Practice Dentistry in Richmond, VA
• Providers in Richmond, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.