Basic Information
| Provider Information | |||||||||
| NPI: | 1457416232 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STODDART | ||||||||
| FirstName: | JANET | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DDS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 721 N OKATIE HWY, P.O. BOX 357 | ||||||||
| Address2: | |||||||||
| City: | RIDGELAND | ||||||||
| State: | SC | ||||||||
| PostalCode: | 29936 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8439877400 | ||||||||
| FaxNumber: | 8439877473 | ||||||||
| Practice Location | |||||||||
| Address1: | BEAUFORT JASPER HAMPTON COMPREHENSIVE HEALTH SERVICES | ||||||||
| Address2: | 721 N OKATIE HWY, 357 | ||||||||
| City: | RIDGELAND | ||||||||
| State: | SC | ||||||||
| PostalCode: | 29936 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8439877400 | ||||||||
| FaxNumber: | 8439873104 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/22/2006 | ||||||||
| LastUpdateDate: | 08/19/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/17/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 122300000X | DEN4672 | ME | N | Dental Providers | Dentist | 122300000X | 046540 | NY | N | Dental Providers | Dentist | 122300000X | 0401416987 | VA | N | Dental Providers | Dentist | 122300000X | 9983 | SC | Y | Dental Providers | Dentist |
No ID Information.