NPIMap

Organization Active NPI

Jebediah S Christy DDS-Charleston PLLC

Doing business as Aspen Dental

  • General Practice Dentistry
  • Charleston, SC
National Provider Identifier
1952851396
Registry record updated Oct 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8613 Issued in SC
Legal business name
JEBEDIAH S CHRISTY DDS-CHARLESTON PLLC
Doing business as
Aspen Dental
Practice address
2051 Sam Rittenberg Blvd
Ste a
Charleston, SC 29407-4620
Phone
(843) 779-6844
NPI assigned
Oct 10, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2016

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

Authorized official

Name
Jebediah S Christy, DDS
Title
Owner
Phone
(315) 454-6000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 8613 SC Primary

Addresses

Primary practice location

2051 Sam Rittenberg Blvd
Ste a
Charleston, SC 29407-4620

Mailing address

PO Box 3189
Syracuse, NY 13220-3189
Phone (315) 454-6000

Other names 1

  • Aspen Dental Doing business as

National Provider Directory

National Provider Directory

Locations

2051 Sam Rittenberg Blvd
Ste A
Charleston, SC 29407
Phone (843) 779-6844

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1476057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476057600000",
    "number": "1952851396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3189",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132203189",
            "telephone_number": "315-454-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2051 SAM RITTENBERG BLVD",
            "address_2": "STE A",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294074620",
            "telephone_number": "843-779-6844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEBEDIAH S CHRISTY DDS-CHARLESTON PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-10",
        "last_updated": "2016-10-10",
        "status": "A",
        "authorized_official_last_name": "CHRISTY",
        "authorized_official_first_name": "JEBEDIAH",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-454-6000",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "8613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aspen Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2016; 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.