NPIMap

Organization Active NPI

Philip a. Vicini DDS.

  • General Practice Dentistry
  • Charleston, WV
National Provider Identifier
1447336870
Registry record updated Mar 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
PHILIP A. VICINI DDS.
Practice address
1086 Martins Branch Road
Charleston, WV 25312
Phone
(304) 984-0052
Fax
(304) 984-3140
NPI assigned
Oct 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2022

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

Authorized official

Name
Mr. Philip A. Vicini, DDSNPI 1497838981
Title
Owner/Dentist
Phone
(304) 984-0052

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 2207 WV
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

1086 Martins Branch Road
Charleston, WV 25312

Mailing address

P.O. Box 13485
Charleston, WV 25360-0485
Phone (304) 984-0052

Other names 1

  • Sissonville Dental Care Center Doing business as

National Provider Directory

National Provider Directory

Locations

1086 Martins Branch Rd
Charleston, WV 25312
Phone (304) 984-0052

Practitioners & affiliated clinicians

Practitioners 2

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": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647216000000",
    "number": "1447336870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 13485",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253600485",
            "telephone_number": "304-984-0052",
            "fax_number": "304-984-3140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1086 MARTINS BRANCH ROAD",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "25312",
            "telephone_number": "304-984-0052",
            "fax_number": "304-984-3140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILIP A. VICINI DDS.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-27",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A",
        "authorized_official_last_name": "VICINI",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "304-984-0052",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WV",
            "license": "2207",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sissonville Dental Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 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.