Individual provider Active NPI

Kent Alexander McBride, D.D.S., M.S.

  • Endodontics
  • Morgantown, WV
National Provider Identifier
1174721393
Registry record updated Oct 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
3682 Issued in WV
Practice address
9000 Coombs Farm Rd Ste 304
Morgantown, WV 26508-1150
Phone
(304) 594-1670
Fax
(304) 594-1671
NPI assigned
Jul 10, 2007
Last updated
Oct 5, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 3682 WV Primary
Endodontics 1223E0200X 14908 MD
Endodontics 1223E0200X DS036617 PA

Addresses

Primary practice location

9000 Coombs Farm Rd Ste 304
Morgantown, WV 26508-1150

Mailing address

9000 Coombs Farm Rd Ste 304
Morgantown, WV 26508-1150
Phone (304) 594-1670

Other practice location 1

1415 River Ave Ste B
Cumberland, MD 21502-4629
Phone (240) 362-7017

Other practice location 2

204 Mary Higginson Ln Ste 100
Uniontown, PA 15401-2657
Phone (724) 438-0600

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
I20151013000395 WV Order and Referring Only - DentistPractitioner - Dentist 3375852437

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
14908MDMDEndodontist
DS036617PAMDEndodontist
3682WVMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Dental Alliance Specialty 2 Endodontics Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1174721393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 COOMBS FARM RD STE 304",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265081150",
            "telephone_number": "304-594-1670",
            "fax_number": "304-594-1671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 COOMBS FARM RD STE 304",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265081150",
            "telephone_number": "304-594-1670",
            "fax_number": "304-594-1671"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1415 River Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "Cumberland",
            "state": "MD",
            "postal_code": "215024629",
            "country_code": "US",
            "telephone_number": "240-362-7017",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "204 Mary Higginson Ln Ste 100",
            "address_purpose": "LOCATION",
            "city": "Uniontown",
            "state": "PA",
            "postal_code": "154012657",
            "country_code": "US",
            "telephone_number": "724-438-0600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCBRIDE",
        "first_name": "KENT",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-10",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "WV",
            "license": "3682",
            "primary": true
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MD",
            "license": "14908",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "PA",
            "license": "DS036617",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

Verify at the official NPI Registry.