Jeffrey S. McCoy Susan Fowler Goodwin D.D.S. Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

JEFFREY S. MCCOY SUSAN FOWLER GOODWIN D.D.S. INC.

Practice address

127 Prosperity LN
Logan, WV 25601-3488

Phone

(304) 752-4801

Fax

(304) 752-4825

NPI assigned

May 17, 2007

Organization subpart

No

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

Authorized official

Name

Jeffrey S McCoy

Title

Owner

Phone

(304) 752-4801

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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

• Shawn Everett Ballard, DDS

  • Dentist
  • Logan, WV
  • NPI 1891280426
  NPD (past)
• Susan Fowler McCoy, DDS

  • General Practice Dentistry
  • Logan, WV
  • NPI 1740325489
  NPD (past)

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245447200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 PROSPERITY LN",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "256013488",
            "telephone_number": "304-752-4801",
            "fax_number": "304-752-4825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 PROSPERITY LN",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "256013488",
            "telephone_number": "304-752-4801",
            "fax_number": "304-752-4825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY S. MCCOY SUSAN FOWLER GOODWIN D.D.S. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCCOY",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-752-4801"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810006292",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shana Hughes
• Betty Joann Hunter, PRSS
• Hurst Medical Equipment Inc
• Marcy Marie Jackson
• Stephanie Jackson
• Kenneth Jeffrey
• Sharon K. Jeffrey, LICSW
• Jolisha Jenkins
• Corey Dillan Johnson
• Haley Johnson

• General Practice Dentistry in Logan, WV
• Providers in Logan, 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 Aug 22, 2020; 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.