NPIMap

Organization Active NPI

Jonathan R Abraham, DDS

  • General Practice Dentistry
  • Charleston, WV
National Provider Identifier
1316330210
Registry record updated Mar 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3622 Issued in WV
Legal business name
JONATHAN R ABRAHAM, DDS
Practice address
3814 Maccorkle Ave SE
Charleston, WV 25304-1528
Phone
(304) 925-0322
Fax
(304) 925-2337
NPI assigned
Mar 17, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2015

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

Authorized official

Name
Dr. Jonathan Robert Abraham, DDSNPI 1538382270
Title
Owner Dentist
Phone
(304) 925-0322

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 3622 WV Primary

Addresses

Primary practice location

3814 Maccorkle Ave SE
Charleston, WV 25304-1528

Mailing address

3814 Maccorkle Ave SE
Charleston, WV 25304-1528
Phone (304) 925-0322

National Provider Directory

National Provider Directory

Locations

3814 Maccorkle Ave SE
Charleston, WV 25304
Phone (304) 925-0322

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1426550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426550400000",
    "number": "1316330210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3814 MACCORKLE AVE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041528",
            "telephone_number": "304-925-0322",
            "fax_number": "304-925-2337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3814 MACCORKLE AVE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041528",
            "telephone_number": "304-925-0322",
            "fax_number": "304-925-2337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JONATHAN R ABRAHAM, DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-17",
        "last_updated": "2015-03-17",
        "status": "A",
        "authorized_official_last_name": "ABRAHAM",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "304-925-0322",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WV",
            "license": "3622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2015; 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.