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General NPI Number Information
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NPI Number | 1194219659
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Entity Type | Organization
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Legal Business Name | CJSWIHART, PLLC
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Dates
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Enumeration Date | 06/19/2018
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Last Update Date | 06/02/2020
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Provider Practice Location Address
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Address Line | 12725 MCMANUS BLVD STE 1B
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City | NEWPORT NEWS
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State | VA
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Zip | 23602-4402
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Country | US
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Telephone | 757-874-0990
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Fax |
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Provider Business Mailing Address
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Address Line | 12725 MCMANUS BLVD STE 1B
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City | NEWPORT NEWS
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State | VA
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Zip | 23602-4402
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Country | US
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Telephone | 757-874-0990
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Fax |
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | DR. CORRIE JEAN SWIHART
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Credential | DDS, MSD
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Telephone | 574-952-6325
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 0401416033
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License Number State | VA
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