Payton Southall, DDS, PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

PAYTON SOUTHALL, DDS, PLLC

Practice address

220 Ragland Rd
Beckley, WV 25801-9721

Phone

(304) 252-0472

NPI assigned

Apr 15, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Payton Southall, DDSNPI 1598332496

Title

Pediatric Dentist

Phone

(304) 252-0472

Specialties & licenses 1

Addresses

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Payton Southall, DDS

  • Dentist
  • Beckley, WV
  • NPI 1598332496
  NPD Authorized official
• Rachel Joy Andrada-Rose, D.D.S.

  • General Practice Dentistry
  • Beckley, WV
  • NPI 1952346827
  NPD (past)
• Paul Todd Rose, D.D.S.

  • Pediatric Dentistry
  • Beckley, WV
  • NPI 1053353334
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1713139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714867200000",
    "number": "1033963020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 SHAWNEE CIR",
            "city": "MOUNT HOPE",
            "state": "WV",
            "postal_code": "258808988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 RAGLAND RD",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258019721",
            "telephone_number": "304-252-0472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAYTON SOUTHALL, DDS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-15",
        "last_updated": "2024-05-05",
        "certification_date": "2024-05-05",
        "status": "A",
        "authorized_official_last_name": "SOUTHALL",
        "authorized_official_first_name": "PAYTON",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "304-252-0472",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Annamoriah Payne, LGSW, MSW
• Leslie Payne
• Lynnetta Faith Payne, D.O.
• Rebekah Payne
• Montana Paynter
• Tommy Payton
• Treasa Lynn Pe, PTA
• Janet Zane Peck, LICSW
• Justin Peck
• Thelma Peck

• Pediatric Dentistry in Beckley, WV
• Providers in Beckley, WV by specialty
• Pediatric Dentistry in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.