Individual provider Active NPI

R Constance Wiener, DMD

  • Dentist
  • Morgantown, WV
National Provider Identifier
1285616474
Registry record updated Dec 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
3741 Issued in WV
Practice address
1 Med Center Dr
Morgantown, WV 26507
Phone
(304) 581-1960
NPI assigned
Nov 15, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 3741 WV Primary

Addresses

Primary practice location

1 Med Center Dr
Morgantown, WV 26507

Mailing address

1 Med Center Dr
Morgantown, WV 26507

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160429000238 WV Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7012216823

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3741WVMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354665600000",
    "number": "1285616474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MED CENTER DR",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "26507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MED CENTER DR",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "26507",
            "telephone_number": "304-581-1960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIENER",
        "first_name": "R CONSTANCE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-15",
        "last_updated": "2012-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WV",
            "license": "3741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

Verify at the official NPI Registry.