Provider Demographics
NPI:1184775397
Name:JI MANAGEMENT, LLC
Entity type:Organization
Organization Name:JI MANAGEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:JI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:804-520-6050
Mailing Address - Street 1:3438 LAUDERDALE DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23233-7528
Mailing Address - Country:US
Mailing Address - Phone:804-360-2100
Mailing Address - Fax:804-360-0734
Practice Address - Street 1:3438 LAUDERDALE DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23233-7528
Practice Address - Country:US
Practice Address - Phone:804-360-2100
Practice Address - Fax:804-360-0734
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA14104251223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty