Active NPI
Antoine Elias Skaff, DDS
- Dentist
- Charleston, WV
National Provider Identifier
1508926874
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Sep 11, 2017.
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 3049
- Practice address
- 4916 Maccorkle Ave SE
Charleston, WV 25304-2052 - Phone
- (304) 925-0234
- NPI assigned
- Dec 9, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 3049 | WV | Primary |
Addresses
Primary practice location
4916 Maccorkle Ave SE
Charleston, WV 25304-2052
Mailing address
4916 Maccorkle Ave SE
Charleston, WV 25304-2052
Phone (304) 925-0234
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0133122000 | Medicaid | WV |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3049 | WV | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165622400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1508926874",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4916 MACCORKLE AVE SE",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "253042052",
"telephone_number": "304-925-0234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4916 MACCORKLE AVE SE",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "253042052",
"telephone_number": "304-925-0234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SKAFF",
"first_name": "ANTOINE",
"middle_name": "ELIAS",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WV",
"license": "3049",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0133122000",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.