Active NPI
Haider Jaffrey, DDS
- General Practice Dentistry
- Fairmont, WV
National Provider Identifier
1336036433
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 4797
- Practice address
- 403 Virginia Ave
Fairmont, WV 26554-2748 - Phone
- (304) 366-9853
- NPI assigned
- Jun 20, 2025
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 4797 | WV | Primary |
Addresses
Primary practice location
403 Virginia Ave
Fairmont, WV 26554-2748
Mailing address
33 Scenery Hill LN
Morgantown, WV 26508-4559
Phone (315) 222-4023
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 |
|---|---|---|---|
| 4797 | WV | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1750377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750377600000",
"number": "1336036433",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33 SCENERY HILL LN",
"city": "MORGANTOWN",
"state": "WV",
"postal_code": "265084559",
"telephone_number": "315-222-4023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "403 VIRGINIA AVE",
"city": "FAIRMONT",
"state": "WV",
"postal_code": "265542748",
"telephone_number": "304-366-9853"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAFFREY",
"first_name": "HAIDER",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-06-20",
"last_updated": "2025-06-20",
"certification_date": "2025-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WV",
"license": "4797",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairmont, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.