Individual provider Active NPI

Edward Lynn Veneri, D.D.S.

  • Dentist
  • Princeton, WV
National Provider Identifier
1144259359
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1924 Issued in WV
Practice address
100 Morrison Dr
Princeton, WV 24740-2322
Phone
(304) 425-8886
NPI assigned
Jul 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 1924 WV Primary

Addresses

Primary practice location

100 Morrison Dr
Princeton, WV 24740-2322

Mailing address

100 Morrison Dr
Princeton, WV 24740-2322
Phone (304) 425-8886

Other identifiers 1

IdentifierTypeStateIssuer
0136092000MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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

Enrollment IDStateProvider typePAC IDDetails
I20190626002849 WV Practitioner - Dentist 3577897461 Practice locations: Princeton, WV

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1144259359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MORRISON DR",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402322",
            "telephone_number": "304-425-8886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MORRISON DR",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402322",
            "telephone_number": "304-425-8886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENERI",
        "first_name": "EDWARD",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-01",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WV",
            "license": "1924",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0136092000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, WV

Sources for this page

Verify at the official NPI Registry.