Organization Active NPI

Joanna S. Luciano Parker, DDS, PLLC

  • General Practice Dentistry
  • Charles Town, WV
National Provider Identifier
1366865552
Registry record updated Jan 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
JOANNA S. LUCIANO PARKER, DDS, PLLC
Practice address
46 Trifecta PL Ste 102
Charles Town, WV 25414-5652
Phone
(304) 725-0508
Fax
(304) 728-8761
NPI assigned
Jan 24, 2014
Last updated
Jan 24, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2014

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

Authorized official

Name
Dr. Joanna Susan Luciano Parker, DDSNPI 1558581272
Title
General Dentist
Phone
(304) 579-7508

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 Dentistry 1223G0001X Primary

Addresses

Primary practice location

46 Trifecta PL Ste 102
Charles Town, WV 25414-5652

Mailing address

46 Trifecta PL Ste 102
Charles Town, WV 25414-5652
Phone (304) 725-0508

Other identifiers 1

IdentifierTypeStateIssuer
06586MedicaidWV

National Provider Directory

National Provider Directory

Locations

46 Trifecta Pl
Ste 102
Charles Town, WV 25414
Phone (304) 725-0508

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1390521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390521600000",
    "number": "1366865552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 TRIFECTA PL STE 102",
            "city": "CHARLES TOWN",
            "state": "WV",
            "postal_code": "254145652",
            "telephone_number": "304-725-0508",
            "fax_number": "304-728-8761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 TRIFECTA PL STE 102",
            "city": "CHARLES TOWN",
            "state": "WV",
            "postal_code": "254145652",
            "telephone_number": "304-725-0508",
            "fax_number": "304-728-8761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOANNA S. LUCIANO PARKER, DDS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-24",
        "last_updated": "2014-01-24",
        "status": "A",
        "authorized_official_last_name": "LUCIANO PARKER",
        "authorized_official_first_name": "JOANNA",
        "authorized_official_middle_name": "SUSAN",
        "authorized_official_title_or_position": "GENERAL DENTIST",
        "authorized_official_telephone_number": "304-579-7508",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06586",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charles Town, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2014; 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.