Provider Demographics
NPI:1194219659
Name:CJSWIHART, PLLC
Entity Type:Organization
Organization Name:CJSWIHART, PLLC
Other - Org Name:SWIHART ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CORRIE
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:SWIHART
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MSD
Authorized Official - Phone:574-952-6325
Mailing Address - Street 1:12725 MCMANUS BLVD STE 1B
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23602-4402
Mailing Address - Country:US
Mailing Address - Phone:757-874-0990
Mailing Address - Fax:
Practice Address - Street 1:12725 MCMANUS BLVD STE 1B
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23602-4402
Practice Address - Country:US
Practice Address - Phone:757-874-0990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-19
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014160331223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty