Kevin Michael Conde, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

WV2667 Issued in WV

Practice address

546 Route 20 South Rd
Buckhannon, WV 26201-3904

Phone

(304) 472-2774

Fax

(304) 472-3927

NPI assigned

Mar 16, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WV

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

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Johns, Conde & Malone, D.D.S., Inc.

  • General Practice Dentistry
  • Buckhannon, WV
  • NPI 1740304971

  General Practice

  NPD (past) Authorized official

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368057600000",
    "number": "1508990722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "546 ROUTE 20 SOUTH RD",
            "city": "BUCKHANNON",
            "state": "WV",
            "postal_code": "262013904",
            "telephone_number": "304-472-2774",
            "fax_number": "304-472-3927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "546 ROUTE 20 SOUTH RD",
            "city": "BUCKHANNON",
            "state": "WV",
            "postal_code": "262013904",
            "telephone_number": "304-472-2774",
            "fax_number": "304-472-3927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONDE",
        "first_name": "KEVIN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2013-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WV",
            "license": "WV2667",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0136833000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "WV2667",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Community Care of West Virginia, Inc.
• Community Care of West Virginia, Inc.
• Community Care Pharmacy of West Virginia Inc
• Conde Family Dentistry
• Andrea Conde
• Margaret Conde
• Betty Lee Conner
• Tuesday F. a. Cook, MD
• Allison Chloe Copenhaver
• Serge Cormier, MD

• All providers in Buckhannon, WV
• General Practice Dentistry in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.