Mountaineer Orthodontics, PLLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

2285 Issued in WV

Legal business name

MOUNTAINEER ORTHODONTICS, PLLC

Doing business as

Drs. Lacy, Weidman & Hazey III

Practice address

112 Hill St
Bridgeport, WV 26330-1756

Phone

(304) 842-5211

Fax

(304) 842-1163

NPI assigned

Apr 25, 2007

Last updated

Sep 12, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael A Hazey III, D.D.S., M.S.

Title

Owner

Phone

(304) 842-5211

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 2

• Drs. Lacy, Weidman & Hazey III Doing business as
• Drs. Weidman and Hazey III, PLLC Other name

Tax ID family

DRS Lacy Weidman Hazey III2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Mountaineer Orthodontics, PLLC

  dba Drs. Lacy, Weidman & Hazey III

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Morgantown, WV
  • NPI 1568682870
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Anna Cathlyn Giles, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Bridgeport, WV
  • NPI 1881116317
  NPD (past)

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757635200000",
    "number": "1356560346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 HILL ST",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263301756",
            "telephone_number": "304-842-5211",
            "fax_number": "304-842-1163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 HILL ST",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263301756",
            "telephone_number": "304-842-5211",
            "fax_number": "304-842-1163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAINEER ORTHODONTICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-25",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A",
        "authorized_official_last_name": "HAZEY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-842-5211",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "D.D.S., M.S."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "WV",
            "license": "2285",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NUMBER",
            "identifier": "177-065-0012",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NUMBER",
            "identifier": "163-924-6887",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NUMBER",
            "identifier": "165-944-8991",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Drs. Lacy, Weidman & Hazey III",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Drs. Lacy, Weidman & Hazey III",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Drs. Weidman and Hazey III, PLLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Mountain State Medical Specialties,Inc.
• Mountainear Audiology & Hearing Aid Center, LLC
• Mountaineer Family Practice PLLC
• Mountaineer Medical Office Building Pharmacy (Mountaineer Medical Pharmacy)
• Mountaineer Medical Pharmacy LLC
• Mountainstate Infectious Disease, PLLC (Mountainstate Infectious Disease)
• Khaldoun Mohamad Mozahem, MD
• Matthew Mullenax
• Megan Muncy, ARNP
• Rachel Marie Muncy

• Orthodontics and Dentofacial Orthopedics Dentistry in Bridgeport, WV
• Providers in Bridgeport, WV by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.

Verify at the official NPI Registry.