Alex Michael Pentino, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30022756 Issued in OH

Practice address

3064 Pennsylvania Ave
Weirton, WV 26062-3721

Phone

(304) 723-5120

NPI assigned

Jul 2, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584316800000",
    "number": "1063675791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 PLAZA DR STE F",
            "city": "SAINT CLAIRSVILLE",
            "state": "OH",
            "postal_code": "439508735",
            "telephone_number": "740-695-5700",
            "fax_number": "740-695-5701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3064 PENNSYLVANIA AVE",
            "city": "WEIRTON",
            "state": "WV",
            "postal_code": "260623721",
            "telephone_number": "304-723-5120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENTINO",
        "first_name": "ALEX",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-02",
        "last_updated": "2020-03-16",
        "certification_date": "2020-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WV",
            "license": "3830",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30022756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sherry Craig Paull
• Sandra Pearce
• William J Pearl, LCSW, LPC
• Judith Peckens, RPH
• Leon J. Pendracky, OD
• Maria Teresa Petrus, MPT
• Edward Michael Phillips, CRNA
• Lisa Marie Phillips
• Christine Piccirillo, RN
• Vincent D Placek, D.D.S.

• General Practice Dentistry in Weirton, WV
• Providers in Weirton, WV by specialty
• General Practice Dentistry in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.