Active NPI
Justin Whetzel, DDS
- Dentist
- Keyser, WV
National Provider Identifier
1427460492
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 4101
- Practice address
- 1035 Florida Ave
Keyser, WV 26726-2804 - Phone
- (304) 788-6647
- Fax
- (301) 777-3624
- NPI assigned
- May 27, 2014
- Last updated
- May 27, 2014
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 4101 | WV | Primary |
Addresses
Primary practice location
1035 Florida Ave
Keyser, WV 26726-2804
Mailing address
10 Lee St
Petersburg, WV 26847-9405
Phone (304) 812-2125
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150408002814 | WV | Order and Referring Only - Oral Surgery | 1557689254 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4101 | WV | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Keyser Family Dentistry, PLLC | Past | Accepting new patients | |
| DRS. Stewart, Barr & Thorne,PLLC | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- General Practice Dentistry
- Keyser, WV
- NPI 1699980466
-
- General Practice Dentistry
- Keyser, WV
- NPI 1164915526
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1401148800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1401148800000",
"number": "1427460492",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 LEE ST",
"city": "PETERSBURG",
"state": "WV",
"postal_code": "268479405",
"telephone_number": "304-812-2125"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1035 FLORIDA AVE",
"city": "KEYSER",
"state": "WV",
"postal_code": "267262804",
"telephone_number": "304-788-6647",
"fax_number": "301-777-3624"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHETZEL",
"first_name": "JUSTIN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-05-27",
"last_updated": "2014-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WV",
"license": "4101",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Keyser, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2014; 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.