Active NPI
Savannah Smiles Youth Dentistry, PC
- General Practice Dentistry
- Savannah, GA
National Provider Identifier
1841265451
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- Legal business name
- SAVANNAH SMILES YOUTH DENTISTRY, PC
- Practice address
- 2127 E Victory Dr
Suite #2
Savannah, GA 31404-3917 - Phone
- (912) 443-6013
- Fax
- (912) 443-6014
- NPI assigned
- Feb 18, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Jenell Stump
- Title
- Director, Licensing & Credentialing
- Phone
- (912) 443-6013
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | Primary |
Addresses
Primary practice location
2127 E Victory Dr
Suite #2
Savannah, GA 31404-3917
Mailing address
2127 E Victory Dr
Savannah, GA 31404-3917
Phone (912) 443-6013
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 539121 | Other | GA | AVESIS |
| ZAG977 | Medicaid | SC | |
| 1888552 | Other | GA | UNITED CONCORDIA |
| 401680528A | Medicaid | GA |
National Provider Directory
National Provider DirectoryLocations
2127 E Victory Dr
Ste 2
Savannah, GA 31404
Phone (912) 443-6013
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140220800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1427328000000",
"number": "1841265451",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2127 E VICTORY DR",
"city": "SAVANNAH",
"state": "GA",
"postal_code": "314043917",
"telephone_number": "912-443-6013",
"fax_number": "912-443-6014"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2127 E VICTORY DR",
"address_2": "SUITE #2",
"city": "SAVANNAH",
"state": "GA",
"postal_code": "314043917",
"telephone_number": "912-443-6013",
"fax_number": "912-443-6014"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SAVANNAH SMILES YOUTH DENTISTRY, PC",
"organizational_subpart": "NO",
"enumeration_date": "2006-02-18",
"last_updated": "2015-03-26",
"status": "A",
"authorized_official_last_name": "STUMP",
"authorized_official_first_name": "JENELL",
"authorized_official_title_or_position": "DIRECTOR, LICENSING & CREDENTIALING",
"authorized_official_telephone_number": "912-443-6013",
"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": "01",
"desc": "Other (non-Medicare)",
"issuer": "AVESIS",
"identifier": "539121",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "ZAG977",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA",
"identifier": "1888552",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "401680528A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Savannah, GA
- Savannah Response Medics LLC
- Savannah Rheumatology Associates, PC
- Savannah Skin Pathology LLC
- Savannah Sleep Consultants LLC (Whole Health Optimization)
- Savannah Sleep Equipment Inc
- Savannah Specialty Home Care, LLC
- Savannah Speech and Hearing Center
- Savannah Speech and Hearing Center Inc
- Savannah Surgery Center, LLC
- Savannah Surgery Center, LLP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.