Provider Demographics
NPI:1487146353
Name:SCOTT, CHRISTOPHER JASON (DDS)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:JASON
Last Name:SCOTT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12034 MISTY RISE CT
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21029-1256
Mailing Address - Country:US
Mailing Address - Phone:410-209-0547
Mailing Address - Fax:
Practice Address - Street 1:10045 BALTIMORE NATIONAL PIKE STE A1
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-3673
Practice Address - Country:US
Practice Address - Phone:410-418-8370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-05
Last Update Date:2018-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD164141223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics