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NPI Code Detail

MEDICARE: JODIE E. MEREDITH, DDS, PLLC

MEDICARE: JODIE E. MEREDITH, DDS, PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QD0000XDental Clinic/Center

General Provider Information

NPI Number : 1447804117
Entity Type Code : Organization
Provider Name (Legal Business Name) : JODIE E. MEREDITH, DDS, PLLC
Provider Business Mailing Address
First Line : 9106 DOVE CREEK PL
Second Line :
City : MECHANICSVILLE
State : VA
Zip : 23116-2868
Country : US
Telephone Number : 757-589-0639
Fax Number :
Provider Business Practice Location Address
First Line : 7239 MECHANICSVILLE TPKE
Second Line :
City : MECHANICSVILLE
State : VA
Zip : 23111-3557
Country : US
Telephone Number : 804-730-9414
Fax Number :
Authorized Official
Title or Position : OWNER
Name : JODIE MEREDITH
Credential : DDS
Telephone Number : 757-589-0639
Provider Enumeration Date : 07/30/2019
Last Update Date : 07/30/2019

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