BALTIMORE SOUTH SMILES YOUTH DENTISTRY, PC
NPI 1568473759
Dentist - General Practice in Baltimore, MD

Q: What is Baltimore South Smiles Youth Dentistry, PC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Active since August 11, 2006

2111 W PATAPSCO AVE, BALTIMORE, MD 21230(410) 644-4100(410) 644-4594 Get Directions Write a Review

NPPES record last updated: July 9, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Baltimore South Smiles Youth Dentistry, Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BALTIMORE SOUTH SMILES YOUTH DENTISTRY, PC (NPI 1568473759) is a healthcare organization registered as a general practice in Baltimore, Maryland and active in the NPI registry since August 2006. The organization lists Jenell Stump, Manager, Licensing Credentialing, as its authorized official.

NPPES Registry Identity

NPI1568473759

Entity TypeOrganization

Primary Taxonomy1223G0001X

Legal Business NameBALTIMORE SOUTH SMILES YOUTH DENTISTRY, PC

Location Address2111 W PATAPSCO AVEBaltimore, MD 21230-2946

Mailing Address16 Arcade Unit 198747Nashville, TN 37219-1994 · (615) 750-0343 · Fax (615) 986-1705

Phone(410) 644-4100

Fax(410) 644-4594

Organization SubpartNo

Authorized OfficialJenell StumpManager, Licensing Credentialing · (615) 750-0343

Enumeration DateAugust 11, 2006

Last NPPES UpdateJuly 9, 2014

✔ NPI 1568473759 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

2111 W PATAPSCO AVE, Baltimore, MD 21230

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Other Identifiers 3

Other111229MD · Dentaquest

Medicaid410647400MD

Medicaid062375100DC

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

FOTINI V ANAGNOSTOPOULOS-KING

Dentist (General Practice)