Active NPI
Jolene Wise, D.D.S.
- General Practice Dentistry
- South Charleston, WV
National Provider Identifier
1265691463
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 3387
- Practice address
- 43 Coventry RDG
South Charleston, WV 25309-9541 - Phone
- (304) 746-0020
- NPI assigned
- Jun 3, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 3387 | WV | Primary |
Addresses
Primary practice location
43 Coventry RDG
South Charleston, WV 25309-9541
Mailing address
PO Box 58304
Charleston, WV 25358-0304
Phone (304) 767-1367
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3387 | WV | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465344000000",
"number": "1265691463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 58304",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "253580304",
"telephone_number": "304-767-1367"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "43 COVENTRY RDG",
"city": "SOUTH CHARLESTON",
"state": "WV",
"postal_code": "253099541",
"telephone_number": "304-746-0020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WISE",
"first_name": "JOLENE",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-06-03",
"last_updated": "2016-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WV",
"license": "3387",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Charleston, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.