Provider Demographics
NPI:1447804117
Name:JODIE E. MEREDITH, DDS, PLLC
Entity Type:Organization
Organization Name:JODIE E. MEREDITH, DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JODIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MEREDITH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:757-589-0639
Mailing Address - Street 1:9106 DOVE CREEK PL
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-2868
Mailing Address - Country:US
Mailing Address - Phone:757-589-0639
Mailing Address - Fax:
Practice Address - Street 1:7239 MECHANICSVILLE TPKE
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23111-3557
Practice Address - Country:US
Practice Address - Phone:804-730-9414
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-30
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental