John Byron Wilfong II, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3375 Issued in WV

Practice address

19 E Main St
Buckhannon, WV 26201-2715

Phone

(304) 472-4954

Fax

(304) 472-8898

NPI assigned

Sep 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• DRS Martino & Wilson, PLLC

  dba Wilson Martino Dental of Buckhannon

  • General Practice Dentistry
  • Buckhannon, WV
  • NPI 1407949639
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427156892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 COST AVE",
            "city": "STONEWOOD",
            "state": "WV",
            "postal_code": "263014811",
            "telephone_number": "304-624-5250",
            "fax_number": "304-624-5251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 E MAIN ST",
            "city": "BUCKHANNON",
            "state": "WV",
            "postal_code": "262012715",
            "telephone_number": "304-472-4954",
            "fax_number": "304-472-8898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILFONG",
        "first_name": "JOHN",
        "middle_name": "BYRON",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WV",
            "license": "3375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL  WV MEDICAL CARD",
            "identifier": "4004052000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Wiehagen
• Jeanie A Wiest, MD
• Anna Lynn Wilfong, DDS
• Courtney N Wilfong
• Halie Wilfong
• John Byron Wilfong III, DDS
• Amanda Williams
• Crystal Gail Williams
• Kaitlyn Williams
• Larry Earl Williams, O.D.

• General Practice Dentistry in Buckhannon, WV
• Providers in Buckhannon, WV by specialty
• General Practice Dentistry in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.