NPIMap

Organization Active NPI

Cheat Lake Family Dentistry

  • General Practice Dentistry
  • Morgantown, WV
National Provider Identifier
1467800417
Registry record updated Jun 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3565 Issued in WV
Legal business name
CHEAT LAKE FAMILY DENTISTRY
Practice address
230 Lakewood Ctr
Morgantown, WV 26508-4457
Phone
(304) 594-9005
NPI assigned
Jun 1, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2016

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

Authorized official

Name
Dr. Allison Wilson
Title
Owner
Phone
(304) 594-9005

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 3565 WV Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 3574 WV

Addresses

Primary practice location

230 Lakewood Ctr
Morgantown, WV 26508-4457

Mailing address

230 Lakewood Ctr
Morgantown, WV 26508-4457

National Provider Directory

National Provider Directory

Locations

230 Lakewood Ctr
Morgantown, WV 26508
Phone (304) 594-9005

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": "1464739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464739200000",
    "number": "1467800417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 LAKEWOOD CTR",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265084457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 LAKEWOOD CTR",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265084457",
            "telephone_number": "304-594-9005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHEAT LAKE FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-01",
        "last_updated": "2016-06-01",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "ALLISON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-594-9005",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "WV",
            "license": "3565",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "WV",
            "license": "3574",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2016; 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.