David A Lattanzi, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

2692 Issued in WV

Practice address

700 West Pike Street
Suite 100
Clarksburg, WV 26301

Phone

(304) 622-4828

Fax

(304) 624-0977

NPI assigned

Nov 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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

• Gino a Gismondi DDS PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Clarksburg, WV
  • NPI 1235544958
  NPD (past)

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265511091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 WEST PIKE STREET",
            "address_2": "SUITE 100",
            "city": "CLARKSBURG",
            "state": "WV",
            "postal_code": "26301",
            "telephone_number": "304-622-4828",
            "fax_number": "304-624-0977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 WEST PIKE STREET",
            "address_2": "SUITE 100",
            "city": "CLARKSBURG",
            "state": "WV",
            "postal_code": "26301",
            "telephone_number": "304-622-4828",
            "fax_number": "304-624-0977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATTANZI",
        "first_name": "DAVID",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WV",
            "license": "2692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0138397000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stanley Lane, L.S.W.
• Brittany Langston, RN
• Rose Lantz
• Atiya M. Lateef, MD
• Ladonna Lathon
• Lorie Lattea
• Kiley Laux
• Samantha Lawrence
• Bradford D Lawson, RPH
• Sydney Nicole Leary

• Oral and Maxillofacial Surgery (Dentist) in Clarksburg, WV
• Providers in Clarksburg, WV by specialty
• Oral and Maxillofacial Surgery (Dentist) in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.