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General NPI Number Information
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NPI Number | 1205779162
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Entity Type | Organization
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Legal Business Name | JCW SOLUTIONS LLC
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Dates
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Enumeration Date | 04/13/2026
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Last Update Date | 04/13/2026
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Provider Practice Location Address
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Address Line | 202 3RD ST E
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City | HAMPTON
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State | SC
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Zip | 29924-2512
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Country | US
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Telephone | 803-943-2191
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Fax |
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Provider Business Mailing Address
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Address Line | 202 3RD ST E
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City | HAMPTON
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State | SC
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Zip | 29924-2512
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Country | US
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Telephone | 803-943-2191
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JARED MICHAEL WHITESIDE
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Credential | DDS
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Telephone | 831-801-6594
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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