NPIMap

Organization Active NPI

Jason R Long DDS, PLLC

  • General Practice Dentistry
  • Williamson, WV
National Provider Identifier
1255670063
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
JASON R LONG DDS, PLLC
Practice address
1628 West 3Rd Ave
Williamson, WV 25661
Phone
(304) 236-2366
Fax
(304) 899-2227
NPI assigned
Feb 14, 2013
Last updated
Aug 20, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2025

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

Authorized official

Name
Jenny Garcia-Rocha
Title
Sr Credentialing Team Lead
Phone
(972) 869-3789

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

1628 West 3Rd Ave
Williamson, WV 25661

Mailing address

1628 West 3Rd Ave
Williamson, WV 25661
Phone (304) 236-2366

National Provider Directory

National Provider Directory

Locations

215 Logan St
Ste 41
Williamson, WV 25661
Phone (304) 236-2366

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1360800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755648000000",
    "number": "1255670063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1628 WEST 3RD AVE",
            "city": "WILLIAMSON",
            "state": "WV",
            "postal_code": "25661",
            "telephone_number": "304-236-2366",
            "fax_number": "304-899-2227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1628 WEST 3RD AVE",
            "city": "WILLIAMSON",
            "state": "WV",
            "postal_code": "25661",
            "telephone_number": "304-236-2366",
            "fax_number": "304-899-2227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JASON R LONG DDS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-14",
        "last_updated": "2025-08-20",
        "status": "A",
        "authorized_official_last_name": "GARCIA-ROCHA",
        "authorized_official_first_name": "JENNY",
        "authorized_official_title_or_position": "SR CREDENTIALING TEAM LEAD",
        "authorized_official_telephone_number": "972-869-3789"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamson, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2025; 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.