NPI 1306159413 · live from the CMS NPI Registry
Jennifer Ballantyne Berwick, DDS
Dentist, Orthodontics and Dentofacial Orthopedics in Charleston, SC. National Provider Identifier 1306159413, active.
NPI record
| NPI | 1306159413 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dentist, Orthodontics and Dentofacial Orthopedics 1223X0400X |
| Practice location | 712 Saint Andrews Blvd, Charleston, SC 29407 |
| Practice phone | 843-571-5533 |
| Mailing address | 376 Sumter St Apt A, Charleston, SC 29403 |
| Enumerated | July 17, 2010 |
| Last updated | September 29, 2012 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, Orthodontics and Dentofacial Orthopedics primary | 1223X0400X | 4396 (SC) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.