Philip Andrew Vicini, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

WV2958 Issued in WV

Practice address

2018 Martins Branch Drive
Sissonville, WV 25312

Phone

(303) 984-0052

Fax

(304) 984-3140

NPI assigned

Oct 20, 2006

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Philip a. Vicini DDS.

  dba Sissonville Dental Care Center

  • General Practice Dentistry
  • Charleston, WV
  • NPI 1447336870
  NPD (past) Authorized official

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1497838981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 DOGWOOD DR",
            "city": "KENNA",
            "state": "WV",
            "postal_code": "252489666",
            "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": "2018 MARTINS BRANCH DRIVE",
            "city": "SISSONVILLE",
            "state": "WV",
            "postal_code": "25312",
            "telephone_number": "303-984-0052",
            "fax_number": "304-984-3140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICINI",
        "first_name": "PHILIP",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WV",
            "license": "WV2958",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0133023000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Courtney Ann Stark
• Barbara C Teel
• Stephen R Thaxton, DC
• Lucindia Ann Toon, P.T.
• Traci Augusta Turley, OTR
• Megan Jamie Wadsworth, COTA/L
• Faye Williamson, PA-C
• Worldwide Chiropractic & Sports Medicine Inc

• General Practice Dentistry in Sissonville, WV
• Providers in Sissonville, WV by specialty
• General Practice Dentistry in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.