Active NPI
David Thomas St Clair, DDS
- Pediatric Dentistry
- Princeton, WV
National Provider Identifier
1275607053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 2131 SPECIALTY 17
- Practice address
- 100 New Hope Road
Medical Arts Clinic Suite 205
Princeton, WV 24740 - Phone
- (304) 487-5437
- NPI assigned
- Nov 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 2131 SPECIALTY 17 | WV | Primary |
| Pediatric Dentistry | 1223P0221X | 0401008536 | VA | |
| Pediatric Dentistry | 1223P0221X | DN10837 | FL |
Addresses
Primary practice location
100 New Hope Road
Medical Arts Clinic Suite 205
Princeton, WV 24740
Mailing address
100 New Hope Road
Medical Arts Clinic Suite 205
Princeton, WV 24740
Phone (304) 487-5437
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0136017000 | Medicaid | WV |
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 |
|---|---|---|---|
| DN10837 | FL | MD | Pediatric Dentist |
| 0401008536 | VA | MD | Pediatric Dentist |
| 2131 SPECIALTY 17 | WV | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1275607053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 NEW HOPE ROAD",
"address_2": "MEDICAL ARTS CLINIC SUITE 205",
"city": "PRINCETON",
"state": "WV",
"postal_code": "24740",
"telephone_number": "304-487-5437"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 NEW HOPE ROAD",
"address_2": "MEDICAL ARTS CLINIC SUITE 205",
"city": "PRINCETON",
"state": "WV",
"postal_code": "24740",
"telephone_number": "304-487-5437"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ST CLAIR",
"first_name": "DAVID",
"middle_name": "THOMAS",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "WV",
"license": "2131 SPECIALTY 17",
"primary": true
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "VA",
"license": "0401008536",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "FL",
"license": "DN10837",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0136017000",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Princeton, WV
Sources for this page
- 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.