NPIMap

Organization Active NPI

WV Pediatric Dentistry PLLC

  • Pediatric Dentistry
  • Martinsburg, WV
National Provider Identifier
1427709682
Registry record updated Jan 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
WV PEDIATRIC DENTISTRY PLLC
Practice address
1004 Sushruta Dr Ste D
Martinsburg, WV 25401-8801
Phone
(205) 249-6175
NPI assigned
Jan 10, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2022

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

Authorized official

Name
Dr. Iiaya Ramanan Rajagopal, BDS
Title
Owner
Phone
(205) 249-6175

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

1004 Sushruta Dr Ste D
Martinsburg, WV 25401-8801

Mailing address

1004 Sushruta Dr Ste D
Martinsburg, WV 25401-8801
Phone (205) 249-6175

Other names 1

  • WV Pediatric Dentistry Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1641772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641772800000",
    "number": "1427709682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1004 SUSHRUTA DR STE D",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254018801",
            "telephone_number": "205-249-6175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 SUSHRUTA DR STE D",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254018801",
            "telephone_number": "205-249-6175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WV PEDIATRIC DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-10",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A",
        "authorized_official_last_name": "RAJAGOPAL",
        "authorized_official_first_name": "IIAYA",
        "authorized_official_middle_name": "RAMANAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "205-249-6175",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "BDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WV Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Martinsburg, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2022; 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.