Individual provider Active NPI

Zachary Ian Law, D.D.S.

  • Dentist
  • Berkeley Springs, WV
National Provider Identifier
1457645467
Registry record updated Jun 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
3688 Issued in WV
Practice address
345 Concord Avenue
Berkeley Springs, WV 25411
Phone
(304) 258-2291
Fax
(304) 258-8188
NPI assigned
Jun 7, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 3688 WV Primary

Addresses

Primary practice location

345 Concord Avenue
Berkeley Springs, WV 25411

Mailing address

345 Concord Avenue
Berkeley Springs, WV 25411
Phone (304) 258-2291

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20160907000190 VA Order and Referring Only - DentistPractitioner - Dentist 3779879473

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3688WVMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1307404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307404800000",
    "number": "1457645467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 CONCORD AVENUE",
            "city": "BERKELEY SPRINGS",
            "state": "WV",
            "postal_code": "25411",
            "telephone_number": "304-258-2291",
            "fax_number": "304-258-8188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 CONCORD AVENUE",
            "city": "BERKELEY SPRINGS",
            "state": "WV",
            "postal_code": "25411",
            "telephone_number": "304-258-2291",
            "fax_number": "304-258-8188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAW",
        "first_name": "ZACHARY",
        "middle_name": "IAN",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-07",
        "last_updated": "2011-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WV",
            "license": "3688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley Springs, WV

Sources for this page

Verify at the official NPI Registry.