NPIMap

Organization Active NPI

Appalachian Oral Surgery Center

  • Oral and Maxillofacial Surgery (Dentist)
  • Morgantown, WV
National Provider Identifier
1104359959
Registry record updated Apr 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
4011 Issued in WV
Legal business name
APPALACHIAN ORAL SURGERY CENTER
Practice address
3433 University Ave
Suite 1
Morgantown, WV 26505-3052
Phone
(304) 322-4532
NPI assigned
Apr 9, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2017

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

Authorized official

Name
Dr. Matthew Elwood Koepke, DDS
Title
Member
Phone
(304) 904-7145

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 4011 WV Primary

Addresses

Primary practice location

3433 University Ave
Suite 1
Morgantown, WV 26505-3052

Mailing address

3433 University Ave
Suite 1
Morgantown, WV 26505-3052
Phone (304) 322-4532

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1491696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491696000000",
    "number": "1104359959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3433 UNIVERSITY AVE",
            "address_2": "SUITE 1",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265053052",
            "telephone_number": "304-322-4532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3433 UNIVERSITY AVE",
            "address_2": "SUITE 1",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265053052",
            "telephone_number": "304-322-4532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APPALACHIAN ORAL SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-09",
        "last_updated": "2017-04-09",
        "status": "A",
        "authorized_official_last_name": "KOEPKE",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "ELWOOD",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "304-904-7145",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WV",
            "license": "4011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2017; 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.